Endoscopic band ligation versus propranolol for the primary prophylaxis of variceal bleeding in cirrhotic patients with high risk esophageal varices

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dc.contributor.authorMaria Perez Ayuso, Rosa
dc.contributor.authorValderrama, Sebastian
dc.contributor.authorEspinoza, Manuel
dc.contributor.authorRollan, Antonio
dc.contributor.authorSanchez, Rene
dc.contributor.authorOtarola, Francisco
dc.contributor.authorMedina, Brenda
dc.contributor.authorRiquelme, Arnoldo
dc.date.accessioned2024-01-10T13:12:44Z
dc.date.available2024-01-10T13:12:44Z
dc.date.issued2010
dc.description.abstractBackground. Gastroesophageal variceal bleeding is a common complication of portal hypertension. Current guidelines recommend beta -blockers for primary prophylaxis. However, evidence suggests that endoscopic variceal ligation (EVL) reduce bleeding episodes. Aims. To compare endoscopic EVL with propranolol (PPL) for primary prophylaxis of variceal bleeding. Methods. We conducted a randomized controlled trial. Over a 9-year period, 75 patients with cirrhosis and high-risk esophageal varices (HREV) were recruited and allocated to EVL (n=39) or PPL (n=36). Primary outcome was variceal bleeding. Secondary outcomes were survival, source of bleeding and serious adverse events. Analyses were made by intention-to-treat. Results. Baseline characteristics were similar. Medium follow-up was 1647 1096 days. Complete follow-up was achieved in 85% of patients. Variceal bleeding occurred in 12% of EVL and in 25% of PPL group (p=0.17). The actuarial risks of bleeding after 2 years were similar in both groups. Overall mortality was 51% in EVL and 33% in PPL group (p=0.17). Patients in the EVL group showed a lower rate of esophageal variceal bleeding (5.1% v/s 25%, p=0.027) and a higher rate of subcardial variceal bleeding compared with PPL group (7.7% v/s 0%, p=0.027). Serious adverse events related to EVL occurred in 2 patients, including 1 death. Conclusions. The present study supports that PPL should be considered the first choice in primary prophylaxis of variceal bleeding offering similar effects and tower severe adverse events compared with EVL.
dc.fechaingreso.objetodigital2024-04-10
dc.format.extent8 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1016/S1665-2681(19)31674-6
dc.identifier.issn1665-2681
dc.identifier.pubmedidMEDLINE:20308718
dc.identifier.urihttps://doi.org/10.1016/S1665-2681(19)31674-6
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/78224
dc.identifier.wosidWOS:000276976800003
dc.information.autorucMedicina;Espinoza M;S/I;10720
dc.information.autorucMedicina;Medina B;S/I;16785
dc.information.autorucMedicina;Otarola F;S/I;3373
dc.information.autorucMedicina;Pérez-Ayuso RM;S/I;100479
dc.information.autorucMedicina;Riquelme A;S/I;3538
dc.information.autorucMedicina;Valderrama S;S/I;120766
dc.issue.numero1
dc.language.isoen
dc.nota.accesocontenido completo
dc.pagina.final22
dc.pagina.inicio15
dc.publisherELSEVIER ESPANA
dc.revistaANNALS OF HEPATOLOGY
dc.rightsacceso abierto
dc.subjectPrimary prophylaxis
dc.subjectEndoscopic band ligation
dc.subjectPropranolol
dc.subjectBeta-Blockers
dc.subjectVariceal bleeding
dc.subjectCirrhosis
dc.subjectRandomized Controlled
dc.subjectRANDOMIZED CONTROLLED TRIAL
dc.subjectPORTAL-HYPERTENSION
dc.subjectPHARMACOLOGICAL-TREATMENT
dc.subjectCONSENSUS WORKSHOP
dc.subjectPLUS NADOLOL
dc.subjectPREVENTION
dc.subjectHEMORRHAGE
dc.subjectMETHODOLOGY
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleEndoscopic band ligation versus propranolol for the primary prophylaxis of variceal bleeding in cirrhotic patients with high risk esophageal varices
dc.typeartículo
dc.volumen9
sipa.codpersvinculados10720
sipa.codpersvinculados16785
sipa.codpersvinculados3373
sipa.codpersvinculados100479
sipa.codpersvinculados3538
sipa.codpersvinculados120766
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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