دورية أكاديمية
Minimal and Maximal Extent of Band Ligation for Acute Variceal Bleeding during the First Endoscopic Session
| العنوان: | Minimal and Maximal Extent of Band Ligation for Acute Variceal Bleeding during the First Endoscopic Session |
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| المساهمون: | Jang Han Jung, Jung Hyun Jo, Sung Eun Kim, Chang Seok Bang, Seung In Seo, Chan Hyuk Park, Se Woo Park, Jo, Jung Hyun |
| بيانات النشر: | Editorial Office of Gut and Liver |
| سنة النشر: | 2022 |
| مصطلحات موضوعية: | End Stage Liver Disease, Esophageal and Gastric Varices* / complications, Esophageal and Gastric Varices* / surgery, Gastrointestinal Hemorrhage / etiology, Gastrointestinal Hemorrhage / surgery, Humans, Liver Cirrhosis / complications, Middle Aged, Retrospective Studies, Severity of Illness Index, Band ligation, Endoscopic hemostasis, Esophageal and gastric varices, Gastrointestinal hemorrhage, Liver cirrhosis |
| الوصف: | Background/aims: The appropriate number of band ligations during the first endoscopic session for acute variceal bleeding is debatable. We aimed to compare the technical aspects of endoscopic variceal ligation (EVL) in patients with variceal bleeding according to the number of bands placed per session. Methods: We retrospectively reviewed multicenter data from patients who underwent EVL for acute variceal bleeding. Patients were classified into minimal EVL (targeting only the foci with active bleeding or stigmata of recent bleeding) and maximal EVL (targeting potential bleeding sources in addition to the aforementioned targets) groups. The primary endpoint was 5-day treatment failure. The secondary endpoints were 30-day rebleeding, 30-day mortality, and intraprocedural adverse events. Results: Minimal EVL was associated with lower rates of hypoxia and shock during EVL than maximal EVL (hypoxia, 0.9% vs 2.9%; shock, 1.3% vs 3.4%). However, treatment failure was higher in the minimal EVL group than in the maximal EVL group (odds ratio, 1.60; 95% confidence interval, 1.06 to 2.41). Age ≥60 years, Model for End-Stage Liver Disease score ≥15, Child-Turcotte-Pugh classification C, presence of hepatocellular carcinoma, and systolic blood pressure <90 mm Hg at initial presentation were also associated with treatment failure. In contrast, 30-day rebleeding and 30-day mortality did not differ between the minimal and maximal EVL groups. Conclusions: Given that minimal EVL was associated with a high risk of treatment failure, maximal EVL may be a better option for variceal bleeding. However, the minimal EVL strategy should be considered in select patients because it does not affect 30-day rebleeding and mortality. ; open |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1976-2283 2005-1212 |
| العلاقة: | GUT AND LIVER; J00954; OAK-2022-02174; https://ir.ymlib.yonsei.ac.kr/handle/22282913/188521Test; T202201426; GUT AND LIVER, Vol.16(1) : 101-110, 2022-01 |
| DOI: | 10.5009/gnl20375 |
| الإتاحة: | https://doi.org/10.5009/gnl20375Test https://ir.ymlib.yonsei.ac.kr/handle/22282913/188521Test |
| حقوق: | CC BY-NC-ND 2.0 KR |
| رقم الانضمام: | edsbas.4EABDEF9 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 19762283 20051212 |
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| DOI: | 10.5009/gnl20375 |