Effects of postoperative use of proton pump inhibitors on gastrointestinal bleeding after endoscopic variceal treatment during hospitalization

Zhang, Yiyan; Wang, Le; Shao, Xiaodong; Zhang, Yongguo; Ma, Shaoze; Peng, Meng-Yuan; Xu, Shi-Xue; Yin, Yue; Guo, Xiaozhong; Qi, Xingshun

doi:10.4240/wjgs.v15.i1.82

Cited by 3 publications

(1 citation statement)

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“…Bleeding after EVL was defined according to the Baveno criteria as follows: (1) recurrent hematemesis, and/or melena, and/or bloody fluid drained by the nasogastric tube or (2) a decrease in hemoglobin by at least 2 g/dL, or a transfusion of more than 2 units of packed RBCs needed within 24 h, or hypovolemic instability [19]. Proton pump inhibitors (PPIs) were not administered after EVL [20,21]. Bleeding-related death was defined as death within 6 weeks of the index bleeding [22].…”

Section: Patientsmentioning

confidence: 99%

Predicting the risk of early bleeding following endoscopic variceal ligation in cirrhotic patients with computed tomography

Ryu,

Kim,

Yoon

et al. 2023

BMC Gastroenterol

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Background Life-threatening bleeding following endoscopic variceal ligation (EVL) in patients with cirrhosis rarely can occur. The present study aimed to evaluate the performance of computed tomography (CT) in predicting the risk of early bleeding following EVL in cirrhotic patients. Methods We retrospectively investigated 285 cirrhotic patients who had undergone EVL. EVL was performed for prophylaxis or acute variceal bleeding. The patients were classified into 2 groups: early bleeding (< 14 days after EVL) and non-early bleeding. We compared baseline characteristics including CT findings between the patient groups. Results Among the 285 patients who underwent EVL treatment, 19 patients (6.7%) experienced early bleeding. On average, these bleeding occurred 9.3 ± 3.5 days after the EVL, with a range of 3 to 13 days. Patients who experience early bleeding had a higher six-week bleeding-related mortality rate compared to those in the non-early bleeding group (31.6% vs. 10.2%; p = 0.014). There was a correlation between the grade of esophageal varix observed during endoscopy and the diameter of esophageal varix observed on CT (p < 0.001). The diameter of esophageal varix on CT was identified as the only significant predictive factor for early bleeding (p = 0.005). Conclusion A larger esophageal varix diameter observed on CT is associated with an increased risk of early bleeding after EVL treatment. Early identification of this high-risk group can provide a change of treatment strategies to improve patient outcomes.

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Section: Patientsmentioning

confidence: 99%