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endoscopic variceal ligation

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https://www.readbyqxmd.com/read/28337234/is-computerised-tomography-better-than-fibreoptic-gastroscopy-for-early-detection-of-gastric-varices
#1
Burak Suvak, Murat Kekilli, Yavuz Beyazıt, Sarper Okten, Alpaslan Tanoglu, Nurgul Sasmaz
INTRODUCTION: Video endoscopic diagnosis of gastric varices is particularly limited, owing to the deep submucosal or subserosal location of the varices and the normal appearance of the overlying mucosa. AIM: We present and emphasise the value of computerised tomography (CT) examination in the early detection of gastric varices (GVs). MATERIAL AND METHODS: In this retrospective study, a total of 216 consecutive patients with cirrhosis were evaluated at the Turkiye Yuksek Ihtisas Training and Research Hospital between September 2008 and March 2011...
2017: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/28303875/-endoscopic-ligation-in-treatment-and-prevention-of-bleeding-from-esophageal-varices
#2
S A Gabriel', A Ya Guchetl', V M Durleshter, V Yu Dyn'ko, D S Murashko, V S Krushel'nitsky
AIM: To demonstrate the efficacy of endoscopic ligation in treatment and prevention of bleeding from esophageal varices in patients with liver cirrhosis and portal hypertension. MATERIAL AND METHODS: We performed a retrospective analysis of 338 patients with liver cirrhosis who underwent ligation for the period 2009 - May 2016. There were 209 (61.8%) men and 129 (38.2%) women. In this group 511 ligations were performed. The total number of ligated nodes was 4086...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28240998/should-we-add-beta-blockers-to-band-ligation-for-secondary-prophylaxis-of-variceal-bleeding
#3
Petre Cotoras, Jorge Faúndez, Roberto Candia
Cirrhotic patients who have had an episode of bleeding from gastroesophageal varices are at high risk of rebleeding, despite treatment with endoscopic variceal ligation. Adding beta-blockers could reduce this risk, but it is associated with adverse effects. Searching in Epistemonikos database, which is maintained by screening multiple databases, we identified seven systematic reviews including 21 randomized controlled trials addressing the question of this article. We extracted data, combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach...
February 23, 2017: Medwave
https://www.readbyqxmd.com/read/28221819/a-prospective-study-of-endoscopic-injection-sclerotherapy-and-endoscopic-variceal-ligation-in-the-treatment-of-esophageal-varices
#4
Syed Mohsin Ali, Shanbin Wu, Hongwei Xu, Hui Liu, Jinghua Hao, Chengyong Qin
INTRODUCTION: The aim of this study was to compare the effectiveness and safety of endoscopic injection sclerotherapy (EIS) with endoscopic variceal ligation (EVL) in the management of esophageal variceal bleeding (EVB). PATIENTS AND METHODS: In this prospective study, we compared the EIS and EVL in 124 patients who had endoscopically proved bleeding from esophageal varices. According to different treatment methods, they were randomly divided into the EIS and the EVL groups...
October 24, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28195875/endoscopic-variceal-ligation-combined-with-argon-plasma-coagulation-versus-ligation-alone-for-the-secondary-prophylaxis-of-variceal-bleeding-a-systematic-review-and-meta-analysis
#5
Xiaoyan Li, Tingting Jiang, Jian Gao
Endoscopic variceal ligation (EVL) is often recommended as an effective method for the treatment of esophageal varices, despite the important tendency of variceal recurrence. Recent studies indicate that combining EVL with argon plasma coagulation (APC) may be a more effective therapy than ligation alone. To investigate these findings, we carried out a systematic review and meta-analysis to compare the safety and efficacy of EVL combined with APC versus ligation alone for the secondary prophylaxis of esophageal variceal hemorrhage...
February 13, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28180928/safety-and-efficacy-of-sodium-tetradecyl-sulfate-and-lipiodol-foam-in-balloon-occluded-retrograde-transvenous-obliteration-brto-for-large-porto-systemic-shunts
#6
Amar Mukund, Ganesh Deogaonkar, S Rajesh, Saggerre Muralikrishna Shasthry, Shiv Kumar Sarin
OBJECTIVE: To evaluate the safety and efficacy sodium tetradecyl sulfate and lipiodol foam (STS foam) in BRTO for large (caliber ≥15 mm) porto-systemic shunt and gastric fundal varices. MATERIALS AND METHODS: It is a retrospective record-based study of patients who underwent BRTO using STS foam at the Institute of Liver and Biliary Sciences, New Delhi, for gastric variceal bleed or refractory hepatic encephalopathy (HE) who had large porto-systemic shunt (diameter ≥15 mm) with or without associated gastric varices...
February 8, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28144613/complete-esophageal-obstruction-after-endoscopic-variceal-band-ligation-in-a-patient-with-a-sliding-hiatal-hernia
#7
Munthir Mansour, Yousef Abdel-Aziz, Hesham Awadh, Nihar Shah, Akash Ajmera
Complete esophageal obstruction is a rare complication of endoscopic variceal banding, with only 6 cases in the English literature since the introduction of endoscopic variceal banding in 1986. We report a case of complete esophageal obstruction following esophageal banding due to entrapment of part of a sliding hiatal hernia. To our knowledge, our case is one of few with esophageal obstruction post-banding, and the first associated with a hiatal hernia. We recommend caution when performing esophageal banding on patients with a hiatal hernia...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28118373/the-role-of-adjuvant-acid-suppression-on-the-outcomes-of-bleeding-esophageal-varices-after-endoscopic-variceal-ligation
#8
Cheng-Kun Wu, Chih-Ming Liang, Chien-Ning Hsu, Tsung-Hsing Hung, Lan-Ting Yuan, Seng-Howe Nguang, Jiunn-Wei Wang, Kuo-Lun Tseng, Ming-Kun Ku, Shih-Cheng Yang, Wei-Chen Tai, Chih-Wei Shih, Pin-I Hsu, Deng-Chyang Wu, Seng-Kee Chuah
The impact of adjuvant acid suppression via proton pump inhibitors or histamine-2 receptor antagonists after endoscopic variceal ligation remains uncertain. We therefore aimed to evaluate the effect of adjuvant acid suppression on the rebleeding and mortality rates in patients who received endoscopic variceal ligation and vasoconstrictor therapy for bleeding esophageal varices. Data from 1997 to 2011 were extracted from the National Health Insurance Research Database in Taiwan. A total of 1576 cirrhotic patients aged > 18 years with a primary diagnosis of acute esophageal variceal bleeding who received endoscopic variceal ligation therapy were screened...
2017: PloS One
https://www.readbyqxmd.com/read/28099882/the-35-year-odyssey-of-beta-blockers-in-cirrhosis-any-gender-difference-in-sight
#9
REVIEW
Maria Antonella Burza, Hanns-Ulrich Marschall, Laura Napoleone, Antonio Molinaro
Cirrhosis is the end-stage of chronic liver disease and leads to the development of portal hypertension and its complications such as esophagogastric varices. Non-selective beta blockers (NSBB) are the keystone for the treatment of portal hypertension since the 1980s and, over the decades, several studies have confirmed their beneficial effect on the prevention of variceal (re)bleeding. Pharmacological studies showed effects of gender, sex hormones, oral contraceptives, and pregnancy on cytochrome P450 (CYPs) enzymes that metabolise NSBB, suggesting that gender differences might exist in the effect of NSBB...
January 15, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28081590/emergency-endoscopic-variceal-ligation-in-cirrhotic-patients-with-blood-clots-in-the-stomach-but-no-active-bleeding-or-stigmata-increases-the-risk-of-rebleeding
#10
Su Jin Kim, Cheol Woong Choi, Dae Hwan Kang, Hyung Wook Kim, Su Bum Park, Young Mi Hong, Ki Tae Yoon, Mong Cho, Hyung Seok Nam, Sm Bakhtiar Ui Islam
BACKGROUND/AIMS: This study aimed to evaluate the efficacy and safety of emergency variceal ligation for the prevention of rebleeding in cirrhotic patients who are found on initial endoscopy to have blood clots in the stomach but no actively bleeding esophageal and gastric varices or stigmata. METHODS: This study included 28 cirrhotic patients who underwent emergency prophylactic EVL and 41 who underwent an elective intervention between January 2009 and June 2014...
December 2016: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28081588/cyanoacrylate-injection-versus-band-ligation-for-bleeding-from-cardiac-varices-along-the-lesser-curvature-of-the-stomach
#11
COMPARATIVE STUDY
Sang Jung Park, Yong Kwon Kim, Yeon Seok Seo, Seung Woon Park, Han Ah Lee, Tae Hyung Kim, Sang Jun Suh, Young Kul Jung, Ji Hoon Kim, Hyunggin An, Hyung Joon Yim, Jae Young Jang, Jong Eun Yeon, Kwan Soo Byun
BACKGROUND/AIMS: Practice guidelines recommend endoscopic band ligation (EBL) and endoscopic variceal obturation (EVO) for bleeding from esophageal varices and fundal varices, respectively. However, the optimal treatment for bleeding from cardiac varices along the lesser curvature of the stomach (GOV1) remains undefined. This retrospective study compared the efficacy between EBL and EVO for bleeding from GOV1. METHODS: Patients treated by EBL or EVO via cyanoacrylate injection for bleeding from GOV1 were enrolled...
December 2016: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28079234/evaluation-of-endoscopic-secondary-prophylaxis-in-children-and-adolescents-with-esophageal-varices
#12
Júlio Rocha Pimenta, Alexandre Rodrigues Ferreira, Eleonora Druve Tavares Fagundes, Paulo Fernando Souto Bittencourt, Alice Mendes Moura, Simone Diniz Carvalho
BACKGROUND: - Bleeding of esophageal varices is the main cause of morbidity and mortality in children and adults with portal hypertension and there are few studies involving secondary prophylaxis in children and adolescents. OBJECTIVE: - To evaluate the efficacy of endoscopic secondary prophylaxis in prevention of upper gastrointestinal bleeding in children and adolescents with esophageal varices. METHODS: - This is a prospective analysis of 85 patients less than 18 years of age with or without cirrhosis, with portal hypertension...
January 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28072750/upper-gastrointestinal-ectopic-variceal-bleeding-treated-with-various-endoscopic-modalities-case-reports-and-literature-review
#13
Sang Woo Park, Eunae Cho, Chung Hwan Jun, Sung Kyu Choi, Hyun Soo Kim, Chang Hwan Park, Jong Sun Rew, Sung Bum Cho, Hee Joon Kim, Mingui Han, Kyu Man Cho
RATIONALE: Ectopic variceal bleeding is a rare (2-5%) but fatal gastrointestinal bleed in patients with portal hypertension. Patients with ectopic variceal bleeding manifest melena, hematochezia, or hematemesis, which require urgent managements. Definitive therapeutic modalities of ectopic varices are not yet standardized because of low incidence. Various therapeutic modalities have been applied on the basis of the experiences of experts or availability of facilities, with varying results...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28052623/prevention-and-treatment-of-variceal-haemorrhage-in-2017
#14
REVIEW
Felix Brunner, Annalisa Berzigotti, Jaime Bosch
Variceal haemorrhage is a major complication of portal hypertension that still causes high mortality in patients with cirrhosis. Improved knowledge of the pathophysiology of portal hypertension has recently led to a more comprehensive approach to prevent all the complications of this condition. Thus, optimal treatment of portal hypertension requires a strategy that takes into account the clinical stage of the disease and all the major variables that affect the risk of progression to the next stage and death...
January 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27875848/multimodal-therapy-of-recurrent-and-refractory-bleeding-from-esophageal-varices-case-report-and-review-of-the-literature
#15
M Buechter, V Penndorf, A Canbay, J M Theysohn, A Dechêne
Bleeding from esophageal varices is a major cause of mortality in patients with advanced liver disease. Although standard treatment and secondary prophylaxis are effective, in some patients sustained hemostasis cannot be achieved. We report the case of a woman with alcoholic liver disease in whom pharmacological, endoscopic, and intravascular therapies failed to control variceal bleeding. Only a combination of (repeated) band ligation, insertion of a self-expanding metal stent, TIPS implantation and redilatation, transjugular variceal embolization, and finally implantation of a portocaval shunt proved to be successful...
December 2016: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/27812446/successful-hemostasis-and-resection-of-a-bleeding-gastric-polyp-by-endoscopic-banding-ligation-in-a-uremic-patient-taking-antiplatelet-agent
#16
Ping-I Hsu, Kwok-Hung Lai, Feng-Woei Tsay, Jin-Shiung Cheng, E-Ming Wang, Rong-Jer Lai, Tsair-Fwu Lee
The modalities to treat bleeding polyps include electrocautery snare polypectomy, adrenaline injection, clipping, argon plasma coagulation and surgery. We hereby describe an endoscopic banding ligation method for the management of bleeding gastric polyp in a patient receiving antiplatelet therapy. A 66-year-old man presented with a five month-history of intermittent tarry stool passage, nausea and fatigue. He had a past history of peripheral arterial occlusive disease and non-insulin dependent diabetes mellitus with end stage renal disease, and regularly took antiplatelet agent (ticlopidine 100 mg thrice daily) for cardiovascular prophylaxis...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27807564/downhill-esophageal-varices-associated-with-central-venous-catheter-related-thrombosis-managed-with-endoscopic-and-surgical-therapy
#17
Joshua C Berkowitz, Sushma Bhusal, Deepak Desai, Maurice A Cerulli, Sumant Inamdar
Downhill esophageal varices are a rare cause of upper gastrointestinal hemorrhage. We present a case of downhill variceal bleeding due to superior vena cava thrombosis resulting from a prior central venous catheter. The patient was managed with endoscopic band ligation and later with surgical axillary vein to right atrium bypass grafting. Successful long-term resolution of varices was achieved at 1 year of follow-up. This is the longest follow-up described for combined endoscopic and surgical management in the existing literature for catheter-associated downhill varices...
August 2016: ACG Case Reports Journal
https://www.readbyqxmd.com/read/27801752/survey-on-clinical-practice-of-primary-prophylaxis-in-portal-hypertension-in-children
#18
Odile Jeanniard-Malet, Mathieu Duché, Alexandre Fabre
Primary prophylaxis in portal hypertension in children is controversial, because there are few studies documenting its efficacy on the risk of bleeding. Twenty-eight centres out of the 38 we contacted returned a completed questionnaire about their clinical practices. More than 75% of the centres use endoscopy to screen patients diagnosed with portal cavernoma, biliary atresia, cystic fibrosis, and other fibrotic chronic liver diseases with suspected portal hypertension. In cases of grade 2 varices with red marks and grade 3 varices >90% of centres perform sclerotherapy or endoscopic variceal ligation...
April 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27784425/-risk-factors-for-early-rebleeding-after-esophageal-variceal-ligation-in-patients-with-liver-cirrhosis
#19
J N Zhou, Z Wei, Z Q Sun
Objective: To investigate the risk factors for early rebleeding after esophageal variceal ligation (EVL) through a multicenter retrospective study. Methods: A total of 3289 patients who were hospitalized and underwent EVL in 17 upper second-class hospitals or hospitals of higher classes from January 1999 to May 2015 were collected and screened according to the exclusion criteria. A total of 2531 patients were screened out, and a retrospective analysis was performed for their clinical data including age, sex, endoscopic findings, and results of laboratory examination (liver function, biochemical results, routine blood test, and coagulation function) to collect related data...
July 20, 2016: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/27779613/child-turcotte-pugh-class-is-best-at-stratifying-risk-in-variceal-hemorrhage-analysis-of-a-us-multicenter-prospective-study
#20
Brett E Fortune, Guadalupe Garcia-Tsao, Maria Ciarleglio, Yanhong Deng, Michael B Fallon, Samuel Sigal, Naga P Chalasani, Joseph K Lim, Adrian Reuben, Hugo E Vargas, Gary Abrams, Michele D Lewis, Tarek Hassanein, James F Trotter, Arun J Sanyal, Kimberly L Beavers, Daniel Ganger, Paul J Thuluvath, Norman D Grace, Roberto J Groszmann
GOALS/BACKGROUND: Data on acute variceal hemorrhage (AVH) in the United States is limited and the best method to stratify risk is not clear. Taking advantage of a prospective US cohort study, we aimed to (1) describe clinical outcomes of AVH and their predictors; (2) compare predictors of 6-week mortality. STUDY: Prospective 15-center US cohort of patients with cirrhosis presenting with endoscopically proven AVH, all of whom received antibiotics, vapreotide (a somatostain analog) infusion and endoscopic band ligation...
October 24, 2016: Journal of Clinical Gastroenterology
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