Aim: To analyze the clinical risk factors for early variceal rebleeding after endoscopic variceal ligation (EVL).
Methods: 342 cirrhotic patients with esophageal varices who received elective EVL to prevent bleeding or rebleeding at our endoscopy center between January 2005 and July 2010. were included in this study. The early rebleeding cases after EVL were confirmed by clinical signs or endoscopy. A case-control study was performed comparing the patients presenting with early rebleeding with those without this complication.
Results: The incidence of early rebleeding after EVL was 7.60%, and the morbidity of rebleeding was 26.9%. Stepwise multivariate logistic regression analysis showed that four variables were independent risk factors for early rebleeding: moderate to excessive ascites [odds ratio (OR) 62.83, 95% CI: 9.39-420.56, P < 0.001], the number of bands placed (OR 17.36, 95% CI: 4.00-75.34, P < 0.001), the extent of varices (OR 15.41, 95% CI: 2.84-83.52, P = 0.002) and prothrombin time (PT) > 18 s (OR 11.35, 95% CI: 1.93-66.70, P = 0.007).
Conclusion: The early rebleeding rate after EVL is mainly affected by the volume of ascites, number of rubber bands used to ligate, severity of varices and prolonged PT. Effective measures for prevention and treatment should be adopted before and after EVL.
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| http://dx.doi.org/10.3748/wjg.v17.i28.3347 | DOI Listing |
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Article Synopsis
- Variceal bleeding is a serious issue for patients with cirrhosis, leading to higher risks of complications and death, particularly after an initial occurrence.
- A systematic review assessed the effectiveness of endoscopic treatments like band ligation and TIPS, which showed better immediate outcomes, compared to pharmacological options like beta-blockers, which help manage long-term risks.
- The study emphasizes tailored treatment plans combining both approaches to improve patient results and calls for further research on long-term benefits and cost-effectiveness.
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