Endoscopic sclerotherapy as compared with endoscopic ligation for bleeding esophagal varices

Use of the Six-Shooter Ligation Device in the Management of Bleeding Esophageal Varices: A Developing-Country Experience

“…In the study by Stiegmann et al (13), variceal obliteration occured in 27 patients of 64 (42%). In the study by Lain et al (12) varices were eradicated in 58% (22/38).…”

“…In the study by Sarin et al (14), the rebleeding rate was 6.4% (3/ In this study, rebleeding was defined as upper GI hemorrhage (hematemsis or melena) before variceal obliteration has occurred. In the study by Stiegmann et al (13), it was defined as a subsequent upper GI hemorrhage that resulted in an unscheduled endoscopy, a need for blood transfusion, or exsanguination, while in the study by Gimson et al (11), it was defined as upper GI hemorrhage that required endoscopy and was associated with a fall in hemoglobin of more than 20 g/L. Lo et al (10) defined rebleeding from esophageal varices as the reappearance of hematemesis or melena after initial success and the bleeding source was confirmed to be from esophageal varices by repeat endoscopy.…”

“…The definition of control of active bleeding varied to some extent in the other trials. Stiegmann et al (13) defined control of active bleeding as the absence of upper gastrointestinal hemorrhage (i.e., stable hematocrit and vital signs, and absence of hematemesis) for 8 hr after treatment, while in the study by Gimson et al (11), control of active variceal hemorrhage was defined as hemostasis 12 hr after the first endoscopic examination with stable vital signs and packed-cell volume and no hematemesis. Hou et al (9) defined success in arresting variceal bleeding as stable vital signs with no sign of rebleeding within 24 hr of treatment, while in the study by Lo et al (10), initial success was defined as cessation of bleeding for more than 72 hr, together with stable vital signs.…”