Small varices in chronic liver diseases

Zhu, Ying; Cheng, Hui; Chen, Jianyong; Huang, Yifei; Líu, Hao; Qi, Xiaolong

doi:10.1097/mog.0000000000000835

Cited by 1 publication

(1 citation statement)

References 98 publications

(134 reference statements)

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“…EIS and EVL were both feasible treatment therapies of emergency endoscopy for hemostasis and preventing rebleeding ( 7 , 8 ). EIS was introduced into clinical practice 50 years before EVL ( 26 ). Unlike EVL, there were many variates in EIS, such as the type and concentration of sclerosing agents, injected volume and location and so on.…”

Section: Discussionmentioning

confidence: 99%

Treatment Strategies in Emergency Endoscopy for Acute Esophageal Variceal Bleeding (CHESS1905): A Nationwide Cohort Study

et al. 2022

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Background and AimsEmergency endoscopy is recommended for patients with acute esophageal variceal bleeding (EVB) and their prognosis has improved markedly over past decades due to the increased specialization of endoscopic practice. The study aimed to compare outcomes following emergency endoscopic injection sclerotherapy (EIS) and endoscopic variceal ligation (EVL) in cirrhotic patients with acute EVB.MethodsCirrhotic patients with acute EVB who underwent emergency endoscopy were retrospectively enrolled from 2013 to 2020 across 34 university hospitals from 30 cities. The primary outcome was the incidence of 5-day rebleeding after emergency endoscopy. Subgroup analysis was stratified by Child-Pugh class and bleeding history. A 1:1 propensity score matching (PSM) analysis was performed.ResultsA total of 1,017 and 382 patients were included in EIS group and EVL group, respectively. The 5-day rebleeding incidence was similar between EIS group and EVL group (4% vs. 5%, P = 0.45). The result remained the same after PSM (P = 1.00). Among Child-Pugh class A, B and C patients, there were no differences in the 5-day rebleeding incidence between the two groups after PSM (P = 0.25, 0.82, and 0.21, respectively). As for the patients with or without bleeding history, the differences between EIS group and EVL group were not significant after PSM (P = 1.00 and 0.26, respectively).ConclusionThe nationwide cohort study indicates that EIS and EVL are both efficient emergency endoscopic treatment strategies for acute EVB. EIS should not be dismissed as an economical and effective emergency endoscopic treatment strategy of acute EVB. ClincialTrials.gov number NCT04307264.

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Section: Discussionmentioning

confidence: 99%