Bleeding from oesophageal ulceration induced by endoscopic variceal ligation for primary prophylaxis

Kumarasena, Ravindu S.; Niriella, Madunil Anuk; Kalubowila, Udaya; Silva, Arjuna P. De; Dassanayake, Anuradha S; Silva, H Janaka de

doi:10.1136/gut.2009.195321

Cited by 3 publications

(7 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The risk of early post‐EVL bleeding has been reported to be approximately 8% . Because all our patients enrolled had large EV with red signs and a history of AVB, we assumed a post‐EVL bleeding rate in the NSLE group of 16% and that by adding SLE and subsequent therapy, the risk for rebleeding could be decreased to 4%.…”

Section: Methodssupporting

confidence: 83%

“…The current study demonstrated that the overall early post‐EVL bleeding rate in patients with large EV and red signs was 9.1%, which was comparable to those of the previous studies . SLE‐guided administration of PAO can reduce post‐EVL bleeding and mortality rates only in patients receiving EVL for AVB.…”

Section: Discussionmentioning

confidence: 99%

“…Although endoscopic variceal ligation (EVL) is considered one of the optimal treatment options for esophageal varices (EV), post‐EVL hemorrhage remains a major concern. The prevalence of post‐EVL bleeding has been reported to range from 7.8% within 6 weeks to 26% within one year from the index EVL . Several studies have focused on the effects of second‐look endoscopy (SLE) after therapeutic endoscopy for non‐variceal gastrointestinal bleeding (GIB) .…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of post-EVL bleeding has been reported to range from 7.8% within 6 weeks to 26% within one year from the index EVL. [7][8][9][10] Several studies have focused on the effects of second-look endoscopy (SLE) after therapeutic endoscopy for non-variceal gastrointestinal bleeding (GIB). 11 However, to our knowledge, there have been no studies evaluating the efficacy of SLE in preventing early post-EVL rebleeding so far.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Second‐look endoscopy‐guided therapy under sedation prevents early rebleeding after variceal ligation for acute variceal bleeding

Wang

Zheng

et al. 2020

J of Digest Diseases

View full text Add to dashboard Cite

Objectives To investigate whether second‐look endoscopy (SLE)‐guided therapy could be used to prevent post‐endoscopic variceal ligation (EVL) early bleeding. Methods Consecutive cirrhotic patients with large esophageal varices (EV) receiving successful EVL for acute variceal bleeding (AVB) or secondary prophylaxis were enrolled. The patients were randomized into a SLE group and a non‐SLE group (NSLE) 10 days after EVL. Additional endoscopic interventions as well as proton pump inhibitors and octreotide administration were applied based on the SLE findings. The post‐EVL early rebleeding and mortality rates were compared between the two groups. Results A total of 252 patients were included in the final analysis. Post‐EVL early rebleeding (13.5% vs 4.8%, P = 0.016) and bleeding‐caused mortality (4.8% vs 0%, P = 0.013) were more frequently observed in the NSLE group than in the SLE group. However, post‐EVL early rebleeding and mortality rates were reduced by SLE in patients receiving EVL for AVB only but not in those receiving secondary prophylaxis. Patients with Child‐Pugh classification B to C at randomization (hazard ratio [HR] 8.77, P = 0.034), AVB at index EVL (HR 3.62, P = 0.003), discontinuation of non‐selective β‐blocker after randomization (HR 4.68, P = 0.001) and non‐SLE (HR 2.63, P = 0.046) were more likely to have post‐EVL early rebleeding. No serious adverse events occurred during SLE. Conclusion SLE‐guided therapy reduces post‐EVL early rebleeding and mortality rates in cirrhotic patients with large EV receiving EVL for AVB.

show abstract

Section: Methodssupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Second‐look endoscopy‐guided therapy under sedation prevents early rebleeding after variceal ligation for acute variceal bleeding

Wang

Zheng

et al. 2020

J of Digest Diseases

View full text Add to dashboard Cite

show abstract

“…Besides, endoscopic variceal ligation (EVL) is the standard procedure for acute variceal bleeding, for secondary prophylaxis, and an alternative to beta‐blockers in primary prophylaxis . However, EVL is associated with a risk of bleeding mainly from a post‐banding ulcer occurring within 2 weeks after the procedure …”

mentioning

confidence: 99%

Is there evidence for stopping anticoagulation therapy before endoscopic variceal ligation?

Guillaume

Bureau

Plessier

2018

Liver International

View full text Add to dashboard Cite

show abstract

Number of endoscopic sessions to eradicate varices identifies high risk of rebleeding in cirrhotic patients

Guo

Zhang

et al. 2022

BMC Gastroenterol

View full text Add to dashboard Cite

Background and aims Risk stratification to identify patients with high risk of variceal rebleeding is particularly important in patients with decompensated cirrhosis. In clinical practice, eliminating gastroesphageal varices thoroughly after sequential endoscopic treatment reduces the rebleeding rate, however, no simple method has been build to predict high risk of variceal rebleeding. We conducted this study to explore the value of the number of endoscopic sessions required to eradicate gastroesphageal varices in identifying high risk of rebleeding. Patients and methods Consecutive cirrhotic patients received sequential endoscopic therapy between January 2015 and March 2020 were enrolled. Endoscopic treatment was performed every 1–4 weeks until the eradication of varices. The primary endpoint was variceal rebleeding. Results A total of 146 patients were included of which 60 patients received standard therapy and 86 patients underwent sequential endoscopic treatment alone. The cut-off value of the number of sequential endoscopic sessions is 3.5 times. Variceal rebleeding was significant higher in patients with endoscopic sessions > 3 times versus ≤ 3 times (61.5% vs. 17.5%, p < 0.001). Variceal rebleeding of patients with endoscopic sessions ≤ 3 times was significant lower than patients with > 3 times in group of standard therapy (19.6% vs. 88.9%, p < 0.001) and endoscopic therapy (15.9% vs. 47.1%, p = 0.028) respectively. Conclusion The number of sequential endoscopic sessions required to eradicate the varices is related to the risk of variceal rebleeding in patients with cirrhosis. If three times of endoscopic treatment can not eradicate the varices, a more aggressive treatment such as TIPS should be seriously considered.

show abstract

Bleeding from oesophageal ulceration induced by endoscopic variceal ligation for primary prophylaxis

Cited by 3 publications

References 4 publications

Second‐look endoscopy‐guided therapy under sedation prevents early rebleeding after variceal ligation for acute variceal bleeding

Second‐look endoscopy‐guided therapy under sedation prevents early rebleeding after variceal ligation for acute variceal bleeding

Is there evidence for stopping anticoagulation therapy before endoscopic variceal ligation?

Number of endoscopic sessions to eradicate varices identifies high risk of rebleeding in cirrhotic patients

Contact Info

Product

Resources

About