AIM: To compare band ligation (BL) with endoscopic sclerotherapy (SCL) in patients admitted to an emergency unit for esophageal variceal rupture. METHODS: A prospective, randomized, single-center study without crossover was conducted. After endoscopic diagnosis of esophageal variceal rupture, patients were randomized into groups for SCL or BL treatment. Sclerotherapy was performed by ethanolamine oleate intravascular injection both above and below the rupture point, with a maximum volume of 20 mL. For BL patients, banding at the rupture point was attempted, followed by ligation of all variceal tissue of the distal esophagus. Primary outcomes for both groups were initial failure of bleeding control (5 d), early re-bleeding (5 d to 6 wk), and complications, including mortality. From May 2005 to May 2007, 100 patients with variceal bleeding were enrolled in the study: 50 SCL and 50 BL patients. No differences between groups were observed across gender, age, Child-Pugh status, presence of shock at admission, mean hemoglobin levels, and variceal size. RESULTS: No differences were found between groups for bleeding control, early re-bleeding rates, complications, or mortality. After 6 wk, 36 (80%) SCL and 33 (77%) EBL patients were alive and free of bleeding. A statistically significant association between Child-Pugh status and mortality was found, with 16% mortality in Child A and B patients and 84% mortality in Child C patients (P<0.001). CONCLUSION: Despite the limited number of patients included, our results suggest that SCL and BL are equally efficient for the control of acute variceal bleeding.
RCT Entities:
AIM: To compare band ligation (BL) with endoscopic sclerotherapy (SCL) in patients admitted to an emergency unit for esophageal variceal rupture. METHODS: A prospective, randomized, single-center study without crossover was conducted. After endoscopic diagnosis of esophageal variceal rupture, patients were randomized into groups for SCL or BL treatment. Sclerotherapy was performed by ethanolamine oleate intravascular injection both above and below the rupture point, with a maximum volume of 20 mL. For BL patients, banding at the rupture point was attempted, followed by ligation of all variceal tissue of the distal esophagus. Primary outcomes for both groups were initial failure of bleeding control (5 d), early re-bleeding (5 d to 6 wk), and complications, including mortality. From May 2005 to May 2007, 100 patients with variceal bleeding were enrolled in the study: 50 SCL and 50 BL patients. No differences between groups were observed across gender, age, Child-Pugh status, presence of shock at admission, mean hemoglobin levels, and variceal size. RESULTS: No differences were found between groups for bleeding control, early re-bleeding rates, complications, or mortality. After 6 wk, 36 (80%) SCL and 33 (77%) EBL patients were alive and free of bleeding. A statistically significant association between Child-Pugh status and mortality was found, with 16% mortality in Child A and B patients and 84% mortality in Child C patients (P<0.001). CONCLUSION: Despite the limited number of patients included, our results suggest that SCL and BL are equally efficient for the control of acute variceal bleeding.
Authors: C K Triantos; J Goulis; D Patch; G V Papatheodoridis; G Leandro; D Samonakis; E Cholongitas; A K Burroughs Journal: Endoscopy Date: 2006-08 Impact factor: 10.093
Authors: Henk R van Buuren; Marijke C Rasch; Piet L Batenburg; Clemens J M Bolwerk; Jan J Nicolai; Sjoerd D J van der Werf; Joost Scherpenisse; Lidia R Arends; Jan van Hattum; Erik A J Rauws; Solko W Schalm Journal: BMC Gastroenterol Date: 2003-08-15 Impact factor: 3.067
Authors: David U Olveda; Remigio M Olveda; Conor Jan Montes; Delia Chy; Jose Modesto B Abellera; Delfin Cuajunco; Alfred K Lam; Donald P McManus; Yuesheng Li; Allen G P Ross Journal: BMJ Case Rep Date: 2014-06-17
Authors: Danielle Roberts; Lawrence Mj Best; Suzanne C Freeman; Alex J Sutton; Nicola J Cooper; Sivapatham Arunan; Tanjia Begum; Norman R Williams; Dana Walshaw; Elisabeth Jane Milne; Maxine Tapp; Mario Csenar; Chavdar S Pavlov; Brian R Davidson; Emmanuel Tsochatzis; Kurinchi Selvan Gurusamy Journal: Cochrane Database Syst Rev Date: 2021-04-10
Authors: Joao Paulo Ribeiro; Sérgio Eiji Matuguma; Spencer Cheng; Paulo Herman; Paulo Sakai; Luiz Augusto Carneiro D'Albuquerque; Fauze Maluf-Filho Journal: Endosc Int Open Date: 2015-08-11
Authors: Fernanda de Quadros Onofrio; Julio Carlos Pereira-Lima; Felipe Marquezi Valença; André Luis Ferreira Azeredo-da-Silva; Airton Tetelbom Stein Journal: Endosc Int Open Date: 2019-10-23