Endoscopic Variceal Ligation Plus Nadolol and Sucralfate Compared With Ligation Alone for the Prevention of Variceal Rebleeding: A Prospective, Randomized Trial

Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis

“…Two randomized trials demonstrate the superiority of combined therapy versus EVL alone. 123,124 Rebleeding rates in these 2 trials were 23% and 14%, respectively, for EVL plus nadolol compared to 47% and 38% for EVL alone. These results support the use of combination therapy to prevent rebleeding, even though a recent consensus conference recommended EVL or ␤-blocker ϩ nitrates as first-line therapy in treatmentnaïve patients.…”

Controlled trial of ligation plus nadolol versus nadolol alone for the prevention of first variceal bleeding

“…Enhanced efficacy by use of beta blockers combined with EVL has been well established in the secondary prophylaxis of variceal bleeding. 16,25 It is still unknown whether a combination of EVL and beta blockers in the primary prophylaxis of variceal bleeding can be similarly effective.…”

“…13 Moreover, varices frequently recur after variceal obliteration achieved by EVL 14 and beta blockers were documented to be able to reduce variceal recurrence. 15,16 Hence, the combination of nadolol and EVL is a rational approach to prevent the first episode of variceal bleeding.…”

Cerebral embolism following N-butyl-2-cyanoacrylate injection for esophageal postbanding ulcer bleed: a case report

“…A study by de la Peña et al (n = 80) [11] showed that four of the 20 rebleeding cases were due to bleeding esophageal ulcers. Similarly, a study by Lo et al (n = 122) [12] showed that seven of the 71 rebleeding episodes were due to esophageal ulcers.…”

“…There is a paucity of data on the incidence of bleeding from such ulcers. Results from secondary prophylaxis trials for esophageal variceal bleed showed that bleeding from postbanding ulcers is relatively uncommon [11,12]. A study by de la Peña et al (n = 80) [11] showed that four of the 20 rebleeding cases were due to bleeding esophageal ulcers.…”