Endoscopic variceal ligation versus sclerotherapy in patients with gastric variceal bleed

内镜下食管静脉曲张结扎术与硬化疗法治疗胃静脉曲张出血的比较

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Abstract

BACKGROUND: The purpose of this study was to evaluate the clinical outcomes and determinants of rebleeding in patients with gastric variceal bleeding undergoing Endoscopic Variceal Ligation (EVL) and Sclerotherapy (EST). METHODS: A retrospective cohort analysis was conducted on patients with gastric variceal bleeding treated with EVL or EST between January 2018 and January 2020. Data were collected from hospital records, including patient demographics, clinical presentation, laboratory results, endoscopic findings, and treatment outcomes. Statistical analysis was performed to compare the efficacy, complications, and rebleeding rates between the two treatment groups. RESULTS: A total of 70 patients were included, with 35 patients in each treatment group (EVL and EST). The baseline characteristics, including etiology of cirrhosis and clinical presentation, were comparable between the groups. Both EVL and EST showed 80% efficacy in controlling initial bleeding. However, long-term rebleeding rates were significantly higher in the EST group (34.3%) compared to the EVL group (11.4%). Factors such as lower RBC and Hb levels, higher bilirubin and AST levels, and prolonged PT and INR were significantly associated with rebleeding in both groups. CONCLUSIONS: Both EVL and EST are effective in managing acute gastric variceal bleeding. However, EVL may offer better long-term outcomes in terms of rebleeding rates. TRIAL REGISTRATION: Not applicable.

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