Banding ligation versus beta-blockers for primary prevention in oesophageal varices in adults

Gluud, Lise Lotte; Krag, Aleksander

doi:10.1002/14651858.cd004544.pub2

Cited by 125 publications

(111 citation statements)

References 88 publications

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“…A Cochrane review of 19 RCTs published in 2012 demonstrated that EVL was associated with significantly lower rates of both upper gastrointestinal bleeding (14 vs. 20%) and AVB (13 vs. 19%), although the beneficial effect of EVL was not confirmed in a sub-group analysis of trials with adequate randomisation or fully published studies. In addition, no difference in mortality was noted between the EVL and NSBB groups [18].…”

Section: Prophylaxis With Endoscopic Variceal Ligation (Evl)mentioning

confidence: 84%

Primary prophylaxis of variceal bleeding

Robertson

Hayes

2018

Hepatol Int

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Section: Prophylaxis With Endoscopic Variceal Ligation (Evl)mentioning

confidence: 84%

Primary prophylaxis of variceal bleeding

Robertson

Hayes

2018

Hepatol Int

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“…Elastic band ligation of haemorrhoids was developed by Barron in 1963 [1] and is now a well-established treatment methodology. Banding of oesophageal varies in both emergency and elective contexts are also an important intervention [2]. Elastic bands have even been utilised as an alternative to umbilical cord clamping [3].…”

Section: Discussionmentioning

confidence: 99%

Elastic Band, Friend or Foe? A Case of Digital Amputation Following Accidental Elastic Band Application and a Review of the Literature

Whitaker¹,

Dempsey²,

Mosahebi³

2013

Emergency Medicine

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“…1), with no differences seen in bleeding-related mortality [29,30]. The strength of the conclusion that EBL is superior to NSBB is, however, significantly limited by the quality of the trials included in the analysis.…”

Section: Clinical Scenarios For the Treatment Of Portal Hypertensionmentioning

confidence: 99%

Therapies: Drugs, Scopes and Transjugular Intrahepatic Portosystemic Shunt - When and How?

Abraldes

Tandon²

2015

Dig Dis

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Variceal bleeding is the most serious complication of portal hypertension. All cirrhotic patients should be screened endoscopically for varices which are present in about 30% of compensated and 60% of decompensated patients at diagnosis. In patients without varices, endoscopy surveillance should be continued every 2 years. Patients with high-risk varices (moderate or large in size, or with red color signs, or in Child-Pugh C patients) should be treated with a nonselective β-blocker to prevent bleeding (propranolol, nadolol or carvedilol). Endoscopic banding ligation is also effective for the prevention of first bleeding, and it is the first choice in patients with contraindications or intolerance to β-blockers. Acute variceal hemorrhage still has a high mortality rate (around 15%) and requires intensive care management and conservative blood transfusion policy. Treatment is based on the combined use of vasoactive drugs, endoscopic band ligation and prophylactic antibiotics. Failures are best managed by transjugular intrahepatic portosystemic shunt (TIPS). Balloon tamponade or specifically designed covered esophageal stents can be used as a bridge to definitive therapy in unstable patients. Early, preemptive TIPS might be the first choice in patients at high risk of failure (Child-Pugh B with active bleeding or Child-Pugh C up to 13 points). Patients surviving a variceal bleeding are at high risk of rebleeding. A combination of β-blockers and endoscopic band ligation is the most effective therapeutic approach. Preliminary data suggest that the addition of simvastatin increases survival in these patients.

show abstract

Banding ligation versus beta-blockers for primary prevention in oesophageal varices in adults

Cited by 125 publications

References 88 publications

Primary prophylaxis of variceal bleeding

Primary prophylaxis of variceal bleeding

Elastic Band, Friend or Foe? A Case of Digital Amputation Following Accidental Elastic Band Application and a Review of the Literature

Therapies: Drugs, Scopes and Transjugular Intrahepatic Portosystemic Shunt - When and How?

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