Acute variceal bleeding: general management

Patch, David; Dagher, Lucy

doi:10.3748/wjg.v7.i4.466

Cited by 17 publications

(13 citation statements)

References 92 publications

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“…Randomized trials that compared EBL to scerotherapy have yielded similar findings, without essentially having difference in the severity of bleeding between both arms. Most of these studies have reported that EBL is generally a safer technique than EIS because it involves a mechanical, less invasive method of variceal obliteration with less systemic and local complications involving the esophageal wall [7,11,[22][23][24][25][26][27][28][29]. For example our data of peritonitis were 19% with EIS versus 6.4% with EBL (p 0.01).…”

Section: Discussionmentioning

confidence: 62%

Management of acute esophageal variceal bleeding by endoscopic sclerotherapy in technically difficult endoscopic band ligation cases—A population based cohort study

Esmat¹,

Hamza²,

Abbas³

et al. 2013

OJGas

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Endoscopic band ligation is regarded as the main therapeutic option for acute esophageal variceal bleeding, while sclerotherapy may be used in the acute setting if ligation is technically difficult. The incidence of difficult-to-perform band ligation in acute esophageal variceal bleeding, as well as the outcome of patients subjected to injection sclerotherapy as an alternative treatment, has not been clearly investigated. Our aim is to study the outcome of patients subjected to injection sclerotherapy in the acute setting of esophageal variceal bleeding when endoscopic band ligation is technically difficult to perform. We included 151 patients with acute esophageal variceal bleeding originnating from medium or large sized varices. All patients were planned for EBL as the 1st treatment option (EBL group 61.6%), meanwhile, EIS using 5% ethanolamine oleate was reserved as the 2nd treatment option when EBL was technically difficult (EIS group 38.4%). The mean time to restore hemodynamic stability was significantly prolonged in the EIS group (11.5 ± 6.5 hrs versus 9.5 ± 5.0 hrs, p 0.05). Initial control of bleeding was significantly higher in the EBL group versus the EIS group (96.7% vs 84.5%, p 0.021). Re-bleeding was more among the EIS group (42.9% vs 24.2%, p 0.04). There were no significant differences as regarding mortality and duration of hospital stay. So, a considerable proportion of cases presenting with acute variceal bleeding will have difficulty in performing EBL. In these patients, sclerotherapy is not a waning procedure with an accepted success rate, without much additional complications and without deranging mortality.

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Section: Discussionmentioning

confidence: 62%

Management of acute esophageal variceal bleeding by endoscopic sclerotherapy in technically difficult endoscopic band ligation cases—A population based cohort study

Esmat¹,

Hamza²,

Abbas³

et al. 2013

OJGas

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“…EVL was the most often used endoscopic procedure (53% of class A, 62% of class B and 69% of class C patients), followed by EST (19,18 and 18% in classes A, B and C, respectively), in combination or not with vasoactive drugs. One physician used sealant injection therapy (Glubran; GEM Srl, Viareggio, Italy), an unconventional method to treat oesophageal varices (20% in classes A and B, and 30% in class C patients).…”

Section: First-line Treatmentmentioning

confidence: 99%

“…The model covers: treatment to stop the bleeding, adverse events (AEs) associated with treatment, and inpatient and outpatient follow-up after treatment. As the risk of rebleeding and death remains high for the first 6 weeks after an initial bleed [16], the timeframe for the analysis is 42 days after admission to the hospital [15,17,18].…”

Section: Modelmentioning

confidence: 99%

Cost of treatment of oesophageal variceal bleeding in patients with cirrhosis in France: results of a French survey

Thabut

Hammer

Cai

et al. 2007

European Journal of Gastroenterology & Hepatology

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“…Ascites was diagnosed clinically and was confirmed by ultrasonography or computed tomography [18]. Variceal bleeding was diagnosed endoscopically [19]. Hepatic encephalopathy was diagnosed based on the presence of temporospatial disorientation, altered level of consciousness, or asterixis in the absence of other possible causes [20].…”

Section: Definitions Of Liver-related Eventsmentioning

confidence: 99%

The Laennec staging system for histological sub-classification of cirrhosis is useful for stratification of prognosis in patients with liver cirrhosis

Kim,

Oh,

Wanless

et al. 2012

Journal of Hepatology

130

112

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Acute variceal bleeding: general management

Cited by 17 publications

References 92 publications

Management of acute esophageal variceal bleeding by endoscopic sclerotherapy in technically difficult endoscopic band ligation cases—A population based cohort study

Management of acute esophageal variceal bleeding by endoscopic sclerotherapy in technically difficult endoscopic band ligation cases—A population based cohort study

Cost of treatment of oesophageal variceal bleeding in patients with cirrhosis in France: results of a French survey

The Laennec staging system for histological sub-classification of cirrhosis is useful for stratification of prognosis in patients with liver cirrhosis

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