Background: Prophylactic endoscopic band ligation (EBL) is used to prevent variceal bleeding in patients with liver cirrhosis. The association of thrombocytopenia, high INR (international normalized ratio) and liver dysfunction with the risk of procedure-related bleeding (PRB) remains debated and recommendations are controversial.
Methods: We analyzed real-life data of cirrhotic patients undergoing elective EBL at two large Viennese centers between Q1/2000-Q1/2018. PRB was defined as bleeding occurring within 30 days after EBL.
Results: We included 617 patients undergoing a total of 1178 prophylactic EBL procedures (median 2 per patient). Sixteen (2.6%) of 617 patients experienced PRB after a median of 12.5 (IQR 17.3) days with no difference in characteristics and laboratory values between the two groups. The proportion of patients with platelets (PLT) < 50 G/L or INR ≥ 1.5 was similar in patients with vs. without PRB. A higher MELD showed a non-significant association with EBL-related bleeding risk (odds ratio, OR 1.07; 95% confidence interval 95% CI 1.00-1.16, p = 0.058). While serum bilirubin was a significant predictor for PRB (OR: 1.10; 95% CI 1.03-1.18), the presence of large varices (OR 0.85 vs. small varices; 95% CI 0.20-3.84), INR (OR 0.50; 95% CI 0.10-3.14), PLT (OR 1.00; 95% CI 1.00-1.01) and the use of non-selective betablockers (OR 1.20; CI 95% 0.38-3.76) were not associated with PRB.
Conclusion: EBL is safe and procedure-related bleedings are rare (2.6%) including in patients with thrombocytopenia < 50 G/L or high INR ≥ 1.5. Only high MELD, and especially high bilirubin seem to be linked to an increased risk of EBL-related bleeding.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522720 | PMC |
| http://dx.doi.org/10.1007/s12072-023-10515-y | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Early rebleeding rate following endoscopic treatment of colonic diverticular bleeding: a systematic review and meta-analysis.
Ann Gastroenterol
December 2024
Department of Hepatology and Gastroenterology, CHU Saint-Pierre, Brussels, Belgium (Jennifer Aoun, Pierre Eisendrath).
Background: Various endoscopic treatment options are available for managing colonic diverticular bleeding (CDB). We conducted a systematic review and meta-analysis to assess the effectiveness of these endoscopic interventions in achieving hemostasis in patients with CDB, focusing on early rebleeding rate (ERR) within 30 days.
Methods: A systematic literature search of the PubMed and Cochrane Library databases was performed for articles published between January 2008 and December 2023.
Gastric Intestinal Metaplasia in Children and Adolescents Is Reversible upon Reaching Adulthood-Results from a Long-Term Cohort Study.
Cancers (Basel)
January 2025
Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia.
Background/objectives: Gastric intestinal metaplasia (GIM) is considered an irreversible preneoplastic precursor for gastric adenocarcinoma in adults. However, its significance in children and the long-term outcome remain poorly understood.
Methods: All children diagnosed with GIM between 2000 and 2020 were identified at a large tertiary referral centre.
Prospects for Narrow Band Imaging Magnification Endoscopy in Oral Lesions: Recommendations from Oral and Maxillofacial Surgeons and a Gastroenterologist.
Cancers (Basel)
December 2024
Division of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Reconstructive Surgery School of Dentistry, Iwate Medical University, Morioka 020-8505, Iwate, Japan.
Narrow band imaging (NBI) magnification endoscopy for the diagnosis of early-stage oral cavity-related cancer and precancerous lesions can recognize oral lesions as brownish areas, and can observe intraepithelial papillary capillary loops (IPCLs) in the mucosa and submucosa to make a qualitative diagnosis of the lesion and highlight the mucosal surface microstructure to facilitate appropriate diagnosis and early treatment. IPCLs are classified from Type 0 to IV: Type 0 is normal mucosa or no blood vessels observed, e.g.
View Article and Find Full Text PDFConstruction of prediction model of early glottic cancer based on machine learning.
Acta Otolaryngol
January 2025
Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Tianjin, China.
Background: The early diagnosis of glottic laryngeal cancer is the key to successful treatment, and machine learning (ML) combined with narrow-band imaging (NBI) laryngoscopy provides a new idea for the early diagnosis of glottic laryngeal cancer.
Objective: To explore the clinical applicability of the diagnosis of early glottic cancer based on ML combined with NBI.
Material And Methods: A retrospective study was conducted on 200 patients diagnosed with laryngeal mass, and the general clinical characteristics and pathological results of the patients were collected.
Impact of narrow band imaging in prediction of histology of advanced colorectal neoplasia.
Sci Rep
January 2025
Department of Internal Medicine, 1st Faculty of Medicine Charles University, Military University Hospital, Prague, Czechia.
We assessed the diagnostic performance of the Narrow-Band Imaging (NBI) International Colorectal Endoscopic Classification (NICE) and the Japan NBI Expert Team classification (JNET) in predicting histological outcomes of advanced colorectal lesions. Additionally, we evaluated the sensitivity and positive predictive value (PPV) of the JNET and NICE classifications individually for high-grade lesions (including HGD adenomas, intramucosal carcinomas, and T1 carcinomas). This was a retrospective analysis of prospectively collected data, involving 211 patients (130 men, mean age 60 years) who underwent colonoscopy with endoscopic resection of advanced colorectal neoplasia (lesions ≥ 10 mm).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!