Asymptomatic Esophageal Varices Should Be Endoscopically Treated

Endoscopic treatment has generally been accepted in the management of bleeding esophageal varices. Both the control of acute variceal bleeding and elective variceal eradication to prevent recurrent bleeding can be achieved via endoscopic methods. In contrast to acute and elective treatment, the role of endoscopic therapy in asymptomatic patients who have never had variceal bleeding remains controversial because of the rather disappointing results obtained from prophylactic sclerotherapy. Most published randomized controlled trials showed that prophylactic sclerotherapy had no effect on survival. In some studies, neither survival rate nor bleeding risk was improved. In this article, the author champions the view that asymptomatic esophageal varices should be endoscopically treated.

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Efficacy of prophylactic sclerotherapy in patients with red color sign negative esophageal varices as a complication in hepatocellular carcinoma: A prospective randomized controlled study

Gastroenterology ◽

10.1016/0016-5085(95)23889-1 ◽

1995 ◽

Vol 108 (4) ◽

pp. A307

Author(s):

H. Miyoshi ◽

A. Matsumoto ◽

M. Oka ◽

K. Yoshimura ◽

K. Sugi ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Esophageal Varices ◽

Randomized Controlled Study ◽

Controlled Study ◽

Randomized Controlled ◽

Red Color ◽

Prophylactic Sclerotherapy

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A Randomized Controlled Study of Fuzheng Huayu Capsule for Prevention of Esophageal Variceal Bleeding in Patients with Liver Cirrhosis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2013/534960 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Jie Gu ◽

Qin Zhang ◽

Dongying Xue ◽

Hong Cai ◽

Lieming Xu

Keyword(s):

Variceal Bleeding ◽

Controlled Trial ◽

Survival Rates ◽

Controlled Study ◽

Esophageal Variceal ◽

Esophageal Variceal Bleeding ◽

Randomized Controlled ◽

Cirrhotic Patients ◽

Upper Gastrointestinal

To elucidate the role of Fuzheng Huayu Capsule, a herbal formula, in the prevention of esophageal variceal bleeding in cirrhotic patients, a multicenter randomized and placebo-controlled trial was carried out. One hundred forty-six cirrhotic patients with esophageal varices were enrolled to compare the probability of upper gastrointestinal bleeding and survival between Fuzheng Huayu Capsule group and controlled group for the duration of 2 years. The results demonstrated that the FZHYC could effectively reduce the risk of variceal bleeding and improve survival rates for cirrhotic patients with varices, especially the combination of the capsule and Propranolol, which presented a better effect; FZHYC could reduce the varices size in patients with small ones. Its effect may be related to the amelioration of hepatic fibrosis.

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Endoscopic sclerotherapy (ES) Vs propranolol (PR) in the elective treatment of variceal bleeding. Preliminary results of a randomized controlled clinical trial

Journal of Hepatology ◽

10.1016/s0168-8278(87)80500-7 ◽

1987 ◽

Vol 5 ◽

pp. S210 ◽

Cited By ~ 4

Keyword(s):

Clinical Trial ◽

Variceal Bleeding ◽

Controlled Clinical Trial ◽

Endoscopic Sclerotherapy ◽

Randomized Controlled Clinical Trial ◽

Preliminary Results ◽

Randomized Controlled ◽

Elective Treatment

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Association of ABO Blood Type with Bleeding Severity in Patients with Acute Gastroesophageal Variceal Bleeding

Medicina ◽

10.3390/medicina57121323 ◽

2021 ◽

Vol 57 (12) ◽

pp. 1323

Author(s):

Wei-Yu Lin ◽

Ming-Yuan Hong ◽

Chih-Hao Lin ◽

Peng-Peng Chang ◽

Shao-Chung Chu ◽

...

Keyword(s):

Variceal Bleeding ◽

Bleeding Risk ◽

Blood Type ◽

Recurrent Bleeding ◽

Gastroesophageal Varices ◽

Blood Types ◽

Significant Difference ◽

Potential Risk Factors ◽

Generalized Linear Mixed Effects ◽

The Impact

Background and Objectives: ABO blood types have been implicated as potential risk factors for various hemorrhagic diseases. No study has investigated the association between gastroesophageal variceal bleeding and ABO blood types. We aimed to evaluate the impact of ABO blood types on mortality and bleeding risk in acute gastroesophageal variceal bleeding. Materials and Methods: This is a retrospective observational study. Patients presenting with acute gastroesophageal varices bleeding diagnosed by endoscopy were enrolled, and were divided by blood type into a type O group and non-type O group. The outcomes were death within 30 days and the proportion of further bleeding. We used generalized linear mixed-effects models to analyze the outcomes. Results: A total of 327 patients and 648 records of emergency room visits were included. The 30-day mortality was 14.8% (21 of 142 patients) in the type O group, and 16.2% (30 of 185 patients) in the non-type O group (p = 0.532). Further bleeding within 30 days occurred in 34 cases (12.6%) in the type O group, and in 26 cases (6.9%) in the non-type O group (p = 0.539). Conclusions: There was no significant difference in blood transfusion volume in 24 h, recurrent bleeding rates, or mortality between patients with blood type O and those with non-type O.

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The Role of Spleen Stiffness in Determining the Severity and Bleeding Risk of Esophageal Varices in Cirrhotic Patients

Medicine ◽

10.1097/md.0000000000001031 ◽

2015 ◽

Vol 94 (24) ◽

pp. e1031 ◽

Cited By ~ 19

Author(s):

Hwi Young Kim ◽

Eun Hyo Jin ◽

Won Kim ◽

Jae Young Lee ◽

Hyunsik Woo ◽

...

Keyword(s):

Esophageal Varices ◽

Bleeding Risk ◽

Spleen Stiffness ◽

Cirrhotic Patients

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ROLE OF STAGE ENDOSCOPIC VARICEAL BAND LIGATION IN TREATMENT OF CHILDREN WITH PORTAL HYPERTENSION

Wiadomości Lekarskie ◽

10.36740/wlek202010105 ◽

2020 ◽

Vol 73 (10) ◽

pp. 2133-2137

Author(s):

Dariia I. Voroniak ◽

Oleg S. Godik ◽

Larysa Ya. Fedoniuk ◽

Olena М. Shapoval ◽

Viktoriia V. Piliponova

Keyword(s):

Portal Hypertension ◽

Esophageal Varices ◽

Variceal Bleeding ◽

Gastric Varices ◽

Secondary Prophylaxis ◽

Band Ligation ◽

Bleeding Prophylaxis

The aim: To evaluate the efficacy of endoscopic variceal band ligation (EVL) after the first esophageal EVL session in children with PH according to endoscopic data. Materials and methods: EVL was performed to 39 patients with PH for the purpose of variceal bleeding primary and secondary prophylaxis. Results: Esophageal varices grade decrease was observed in 22 (56.41%) children. Cases of early rebleeding (within 14 days after EVL) were not registered. Eradication of varices was successful in 11 (28.2%) of patients. In 1 (2.56%) case the complication (bleeding) occurred while banding procedure. 1 (2.56%) patients had bleeding from gastric varices prior to a control endoscopy. Portal gastropathy grade changes were observed in 17 (43.59%) patients. Conclusions: EVL is a safe and effective method of esophageal varices bleeding prophylaxis. This method allows control the esophageal varices grade at different phases of PH treatment in children. Even one EVL session can decrease the grade of esophageal varices (р<0.001). The EVL effect on the severity of portal gastropathy (p=0.02) and on the red marks presence (p=0.005) was also determined. EVL reduced the risk of variceal rebleeding (р=0.05, RR=0.05 (95%CI 0.01-0.32)).

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