Sclerotherapy versus beta-blockers for primary prophylaxis of oesophageal variceal bleeding in children and adolescents with chronic liver disease or portal vein thrombosis

Gattini, Daniela; Cifuentes, Lorena; Torres‐Robles, Romina; Gana, Juan Cristóbal

doi:10.1002/14651858.cd011659.pub2

Cited by 11 publications

(6 citation statements)

References 62 publications

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“…66 Prophylactic coverage of non-selective β blockers for patients at high risk might be an alternative if screening cannot be arranged. 67 For patients with suspected, probable, or confirmed COVID-19, endoscopy should only be done for emergency or urgent indications, with strict isolation precautions and ideally in a negative-pressure room (statement 9D; table 1). As some endoscopy units might not have a negative-pressure room, the procedure can be done in a venue outside of the endoscopy centre (eg, with negative pressure in the operation theatre or in a room with improved ventilation).…”

Section: Scenario 9: How Should Variceal Screening Be Done During the Covid-19 Pandemic?mentioning

confidence: 99%

Management of patients with liver derangement during the COVID-19 pandemic: an Asia-Pacific position statement

Wong

Thompson

et al. 2020

The Lancet Gastroenterology & Hepatology

108

107

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on behalf of the Asia-Pacific Working Group for Liver Derangement during the COVID-19 Pandemic The COVID-19 pandemic has spread rapidly worldwide. It is common to encounter patients with COVID-19 with abnormal liver function, either in the form of hepatitis, cholestasis, or both. The clinical implications of liver derangement might be variable in different clinical scenarios. With growing evidence of its clinical significance, it would be clinically helpful to provide practice recommendations for various common clinical scenarios of liver derangement during the COVID-19 pandemic. The Asia-Pacific Working Group for Liver Derangement during the COVID-19 Pandemic was formed to systematically review the literature with special focus on the clinical management of patients who have been or who are at risk of developing liver derangement during this pandemic. Clinical scenarios covering the use of pharmacological treatment for COVID-19 in the case of liver derangement, and assessment and management of patients with chronic hepatitis B or hepatitis C, non-alcoholic fatty liver disease, liver cirrhosis, and liver transplantation during the pandemic are discussed.

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Section: Scenario 9: How Should Variceal Screening Be Done During the Covid-19 Pandemic?mentioning

confidence: 99%

Management of patients with liver derangement during the COVID-19 pandemic: an Asia-Pacific position statement

Wong

Thompson

et al. 2020

The Lancet Gastroenterology & Hepatology

108

107

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“…Bleeding from esophageal varices is a life-threatening condition with an incidence of 5%-15% in patients with liver cirrhosis and mortality rates of at least 20% [11,12] .The therapeutic methods for esophageal varices include EIS, EVL, nonselective β-blockers, TIPS, shunt surgery, and so on [13][14][15][16] .…”

Section: Discussionmentioning

confidence: 99%

A transparent cap assisted endoscopic injection sclerotherapy for the treatment of patients with esophageal varices

Wang

Zhang

Zhao

2020

Preprint

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Aim: The aim of this study was to compare the efficacy and safety of cap assisted endoscopic injection sclerotherapy(EIS) versus direct endoscopic injection sclerotherapy(EIS) in the management of patients with cirrhosis after esophageal variceal bleeding .Methods: Patients with cirrhosis suffering from esophageal variceal bleeding who underwent EIS with or without the help of a transparent cap in Shandong Provincial Hospital between Novermber December 2014 and April 2017 were included in this retrospective study. All of the cases included in the study were divided into two groups: Group A (EIS with a transparent cap, n=50), Group B (direct EIS, n=45). Data collected included patients' demographics, details of the procedure, variceal eradication, variceal rebleeding, variceal recurrence and survival during the follow-up period. All data were expressed as mean ± SD. Quantitative variables were compared by Student t test, and qualitative variables were compared by the Fisher exact test or the chi-square test. A P value less than 0.05 was considered significant.Results: The mean duration of follow-up was similar in both groups(16.3±10.2 mo and 15.5±9.5 mo, respectively). To achieve the eradication of varices, the volume of sclerosant (64.86±10.62 ml vs 104.73±21.25 ml, P =0.044), the mean number of sessions (2.37±1.15 times vs 5.70±1.57 times, p =0.042), the time required to perform endoscopic treatment(6.57±1.50 minutes vs 11.22±2.29 minutes, P =0.049) and the time for the initial esophageal varices eradication were significantly reduced in the cap assisted EIS group than in the direct EIS group(5.43±1.38 weeks vs 8.93±1.5 weeks, P =0.041). The probability of variceal recurrence and rebleeding was significantly higher in the direct EIS group than in cap assisted EIS group. Only 22 patients (44%) developed complications in the cap assisted EIS group as compared to 30 patients ( P =0.039) in the EIS group. The probability of survival was similar in both groups ( P =0.133).Conclusion: EIS with a transparent cap is an effective and safe treatment for esophageal varices. BackgroundEsophageal variceal bleeding is a major cause of morbidity in patients with cirrhosis. Endoscopic variceal ligation (EVL) and endoscopic injection sclerotherapy(EIS) were widely used to treat

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“…Эндоскопическая инъекционная склеротерапия относится к первичной профилактике варикозных кровотечений при циррозе печени [9]. Этот метод является инвазивным, дорогостоящим и связан с потенциально опасными для жизни осложнениями.…”

Section: склеротерапияunclassified

“…Рандомизированные испытания показали наибольший эффект на остановку кровотечения (для начального пятидневного контроля), но, как ни странно, не повлияли на смертность. Этот кажущийся парадокс можно объяснить большой вариабельностью показателей эффективности склеротерапии, используемой отдельно в этой группе исследований, что затрудняет интерпретацию метаанализа [9].…”

Section: склеротерапияunclassified

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Evaluation of the Effectiveness of Various Methods of Primary Prevention of Varicose Bleeding in Patients With Liver Cirrhose

Sopuev¹,

Apsamatov²,

Ernisova³

2022

НО МН (SR MS)

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В статье представлены методы профилактики кровотечений из варикозно расширенных вен пищевода у больных с циррозом печени. Пациентам со средним и большим варикозным расширением вен в качестве наиболее эффективного метода первичной профилактики варикозного кровотечения предложены две стратегии: использование неселективных бета-блокаторов (НСБАБ) и эндоскопическая варикозная перевязка (ЭВП). Имеющиеся данные свидетельствуют о том, что вазоактивные препараты в сочетании с эндоскопической терапией и антибиотиками являются лучшей стратегией лечения, а ЭВЛ является эндоскопической процедурой выбора. При неконтролируемом кровотечении рекомендуется трансъюгулярный внутрипеченочный портосистемный шунт (ТВПШ) со стентами, покрытыми политетрафторэтиленом (ПТФЭ). По данным анализа литературы вторичная профилактика должна начинаться на шестой день после начального эпизода кровотечения. Комбинация НСБАБ и ЭВЛ является рекомендуемым лечением, тогда как ТВПШ со стентами, покрытыми ПТФЭ, является предпочтительным вариантом у пациентов, которые не проходят эндоскопическое и фармакологическое лечение. Также известны другие методы остановки варикозного кровотечения, такие как тканевые адгезивы, эндоскопическое клипирование и коагуляция аргоновой плазмой, эффективность и безопасность которых еще предстоит дополнительно выяснить.

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Sclerotherapy versus beta-blockers for primary prophylaxis of oesophageal variceal bleeding in children and adolescents with chronic liver disease or portal vein thrombosis

Abstract: Sclerotherapy versus beta-blockers for primary prophylaxis of oesophageal variceal bleeding in children and adolescents with chronic liver disease or portal vein thrombosis.

Cited by 11 publications

References 62 publications

Management of patients with liver derangement during the COVID-19 pandemic: an Asia-Pacific position statement

Management of patients with liver derangement during the COVID-19 pandemic: an Asia-Pacific position statement

A transparent cap assisted endoscopic injection sclerotherapy for the treatment of patients with esophageal varices

Evaluation of the Effectiveness of Various Methods of Primary Prevention of Varicose Bleeding in Patients With Liver Cirrhose

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