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Hong HJ, Jun CH, Lee du H, et al. Comparison of Endoscopic Variceal Ligation and Endoscopic Variceal Obliteration in Patients with GOV1 Bleeding. Chonnam Med J. 2013;49(1):14-9doi: 10.4068/cmj.2013.49.1.14.
Hong, H. J., Jun, C. H., Lee, d. u. . H., Cho, E. A., Park, S. Y., Cho, S. B., Park, C. H., Joo, Y. E., Kim, H., Choi, S. K., & Rew, J. S. (2013). Comparison of Endoscopic Variceal Ligation and Endoscopic Variceal Obliteration in Patients with GOV1 Bleeding. Chonnam medical journal, 49(1), 14-9. https://doi.org/10.4068/cmj.2013.49.1.14
Hong, Hyoung Ju, et al. "Comparison of Endoscopic Variceal Ligation and Endoscopic Variceal Obliteration in Patients with GOV1 Bleeding." Chonnam medical journal vol. 49,1 (2013): 14-9. doi: https://doi.org/10.4068/cmj.2013.49.1.14
Hong HJ, Jun CH, Lee du H, Cho EA, Park SY, Cho SB, Park CH, Joo YE, Kim H, Choi SK, Rew JS. Comparison of Endoscopic Variceal Ligation and Endoscopic Variceal Obliteration in Patients with GOV1 Bleeding. Chonnam Med J. 2013 Apr;49(1):14-9. doi: 10.4068/cmj.2013.49.1.14. Epub 2013 Apr 25. PMID: 23678472; PMCID: PMC3651981.
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Chonnam Med J. 2013 Apr;49(1):14-9. doi: 10.4068/cmj.2013.49.1.14. Epub 2013 Apr 25.

Comparison of Endoscopic Variceal Ligation and Endoscopic Variceal Obliteration in Patients with GOV1 Bleeding.

Chonnam medical journal

Hyoung Ju Hong, Chung Hwan Jun, Du Hyeon Lee, Eun Ae Cho, Seon Young Park, Sung Bum Cho, Chang Hwan Park, Young Eun Joo, Hyunsoo Kim, Sung Kyu Choi, Jong Sun Rew

Affiliations

  1. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.

PMID: 23678472 PMCID: PMC3651981 DOI: 10.4068/cmj.2013.49.1.14

Abstract

The aim of this study was to compare the efficacy, rebleeding rates, survival, and complications of endoscopic variceal ligation (EVL) with those of endoscopic variceal obliteration (EVO) in patients with acute type 1 gastroesophageal variceal (GOV1) bleeding. Data were collected retrospectively at a single center. A total of 84 patients were selected (20 patients underwent EVL; 64 patients underwent EVO) from February 2004 to September 2011. Their clinical characteristics, laboratory results, vital signs, Child-Pugh score, Model for End-stage Liver Disease (MELD) score, and overall mortality were evaluated. There were no significant differences in baseline characteristics between the two groups. The success rate in initial control of active bleeding was not significantly different between the EVL and EVO groups (18/20 EVL, or 90.0%, compared with 62/64 EVO, or 96.9%; p=0.239). The early rebleeding rate was also not significantly different between the groups (3/18 EVL, or 16.7% compared with 17/62 EVO, or 27.4%; p=0.422). The late rebleeding rate of the EVL group was lower than that of the EVO group (3/18 EVL, or 16.7%, compared with 26/59 EVO, or 44.1%; p=0.042). The time-to-rebleeding was 594 days for the EVL group and 326 days for the EVO group (p=0.054). In the multivariate analysis, portal vein thrombosis (PVT) was a significant risk factor for early rebleeding. Hepatocellular carcinoma (HCC) and previous history of bleeding were significant risk factors for very late rebleeding. In conclusion, EVL is better than EVO in reducing late rebleeding in acute GOV1 bleeding. HCC, PVT, and previous bleeding history were significant risk factors for rebleeding.

Keywords: Endoscopy; Esophageal and gastric varices; Hemostasis; Risk factors

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