Journal of the Chinese Medical Association
Volume 69, Issue 12 , Pages 553-560 , December 2006

Prevention of Esophageal Variceal Rebleeding

  • Gin-Ho Lo

      Affiliations

    • Corresponding Author InformationCorrespondence to: Dr Gin-Ho Lo, Division of Gastroenterology, Department of Medicine, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan, R.O.C.

Received 11 July 2006 ,Accepted 25 October 2006.

References 

  1. Graham DY , Smith JL . The course of patients after variceal hemorrhage . Gastroenterology . 1981;80:800–809
  2. Chen WC , Lo GH , Tsai WL , Hsu PI , Lin CK , Lai KH . Emergency endoscopic variceal ligation versus somatostatin for acute esophageal variceal bleeding . J Chin Med Assoc . 2006;69:60–67
  3. Lo GH, Lai KH, Ng WW, Tam TN, Lee SD, Tsai YT, et al. Injection sclerotherapy preceded by esophageal tamponade versus immediate sclerotherapy in arresting active variceal bleeding: a prospective randomized trial . Gastrointest Endosc . 1992;38:421–424
  4. Mihas AA , Sanyal AJ . Recurrent variceal bleeding despite endo-scopic and medical therapy . Gastroenterology . 2004;127:621–629
  5. Lo GH , Lai KH . The factors affecting risk of recurrent variceal bleeding . Gastroenterology . 2005;128:244–245
  6. Hou MC, Lin HC, Kuo BIT, Liao TM, Lee FY, Chang FY, et al. Sequential variceal pressure measurement by endo-scopic needle puncture during maintenance sclerotherapy: the correlation between variceal pressure and variceal rebleeding . J Hepatol . 1998;29:772–778
  7. Burroughs AK, Cales P, Kravetz D, Riggio O, Tbabut D, van Buuren HR, et al. Definition of key events – last attempt? . In:  de Franchis R editors. Portal hypertension. Proceedings of the Fourth Baveno International Consensus Workshop on Methodology of Diagnosis and Treatment . Oxford: Blackwell Science; 2006;p. 11–39
  8. Peraccbia A , Battaglia G , Baisi A . From Eck's fistula to liver transplantation: a critical look at surgery for portal hypertension . In:  de Franchis R editors. Portal hypertension II. Proceedings of the Second Baveno International Consensus Workshop on Definitions, Methodology and Therapeutic Strategies . Oxford: Blackwell Science; 1996;p. 140–150
  9. Henderson JM . Role of distal splenorenal shunt for long-term management of variceal bleeding . World J Surg . 1994;18:205–210
  10. Grace ND, Conn HO, Resnick RH, Groszmann RJ, Atterbury CE, Wright SC, et al  Distal splenorenal vs. portal-systemic shunts after hemorrhage from varices: a randomized controlled trial . Hepatology . 1988;8:1475–1481
  11. Crafoord C , Frenckner P . New surgical treatment of varicose veins of the esophagus . Acta Otolaryngol (Stockholm) . 1939;27:422–429
  12. Conn HO . Endoscopic sclerotherapy: an analysis of variants . Hepatology . 1983;3:769–771
  13. Johnston GW , Rodgers HW . A review of 15 years' experience in the use of sclerotherapy in the control of acute hemorrhage from esophageal varices . Br J Surg . 1973;60:797–800
  14. Williams R , Westaby D . Endoscopic sclerotherapy for esophageal varices . Dig Dis Sci . 1986;31:108–121
  15. Schuman BM , Beckman JW , Tedesco FJ , Griffin JW , Assad RT . Complications of endoscopic injection sclerotherapy: a review . Am J Gastroenterol . 1987;82:823–830
  16. de Franchis R , Primignani M . Endoscopic treatments for portal hypertension . Sem Liver Dis . 1999;19:439–455
  17. Infante-Rivard C , Esnaola S , Villeneuve JP . Role of endoscopic variceal sclerotherapy in the long-term management of variceal bleeding: a meta-analysis . Gastroenterology . 1989;96:1087–1092
  18. Lai KH, Chiang TT, Tsai YT, Lee SD, Ng WW, Wang JY, et al  Follow-up study after endoscopic injection sclerotherapy . Chin J Gastroenterol . 1985;2:164–170
  19. Cheng CY, Chen GH, Chang CS, Tseng CC, Chen TY, Lin CK, et al  Sclerotherapy on liver cirrhosis with esophageal variceal bleeding: eight years of experience . J Chin Med Assoc . 1994;54:321–328
  20. Lebrec D , Poynard T , Hillon P , Benhamou JP . Propranolol for prevention of recurrent gastrointestinal bleeding in patients with cirrhosis: a controlled study . N Engl J Med . 1981;305:1371–1374
  21. Bernard B , Lebrec D , Mathurin P , Opolon P , Poynard T . Beta-adrenergic antagonists in the prevention of gastrointestinal rebleeding in patients with cirrhosis: a meta-analysis . Hepatology . 1997;25:63–70
  22. Sheen IS , Chen Y , Liaw YF . Randomized controlled study of propranolol for prevention of recurrent esophageal varices bleeding in patients with cirrhosis . Liver . 1989;9:1–5
  23. Garcia-Pagan JC , Navasa M , Bosch J , Bru C , Pizcueta P , Rodes J . Enhancement of portal pressure reduction by the association of isosorbide-5-mononitrate to propranolol administration in patients with cirrhosis . Hepatology . 1990;11:230–238
  24. Gournay J , Masliah C , Martin T , Perrin D , Galmiche JP . Isosorbide mononitrate and propranolol compared with pro-pranolol alone for the prevention of variceal rebleeding . Hepatology . 2000;31:1239–1245
  25. Bernard B , Lebrec D , Mathurin P , Opolon P , Poynard T . Propranolol and sclerotherapy in the prevention of gastrointestinal rebleeding in patients with cirrhosis: a meta-analysis . J Hepatol . 1997;26:312–324
  26. Villanueva C, Balanzo J, Novella MT, Soriano G, Sainz S, Torras X, et al  Nadolol plus isosorbide mononitrate compared with sclerotherapy for the prevention of variceal rebleeding . N Engl J Med . 1996;334:1624–1629
  27. Stiegmann GV , Goff JS , Sun JH , Davis D , Silas D . Technique and early clinical results of endoscopic variceal ligation (EVL) . Surg Endosc . 1989;3:73–78
  28. Stiegmann GV, Goff JS, Michaletz-Onody PA, Korula J, Lieberman D, Saeed ZA, et al  Endoscopic sclero-therapy as compared with endoscopic ligation for bleeding esophageal varices . N Engl J Med . 1992;326:1527–1532
  29. Laine L , El-Newihi HM , Migikovsky B , Sloane R , Garcia F . Endoscopic ligation compared with sclerotherapy for the treatment of bleeding esophageal varices . Ann Intern Med . 1993;119:1–7
  30. Gimson AES, Ramage JK, Panos MZ, Hayllar K, Harrison PM, Williams R, et al  Randomised trial of variceal banding ligation versus injection sclerotherapy for bleeding esophageal varices . Lancet . 1993;342:391–394
  31. Lo GH, Lai KH, Cheng JS, Hwu JH, Chang CF, Chen SM, et al. A prospective, randomized trial of sclerotherapy versus ligation in the management of bleeding esophageal varices . Hepatology . 1995;22:466–471
  32. Hou MC , Lin HC , Kuo BIT , Chen CH , Lee FY , Lee SD . Comparison of endoscopic variceal injection sclerotherapy and ligation for the treatment of esophageal variceal hemorrhage: a prospective randomized trial . Hepatology . 1995;21:1517–1522
  33. Laine L . Ligation: endoscopic treatment of choice for patients with bleeding esophageal varices? . Hepatology . 1995;22:663–665
  34. Sarin SK , Govil A , Jain AK . Prospective randomized trial of endoscopic sclerotherapy versus variceal band ligation for esophageal varices: influence on gastropathy, gastric varices and variceal recurrence . J Hepatol . 1997;26:826–832
  35. Stiegmann GV , Goff JS . Endoscopic esophageal varix ligation: preliminary clinical experience . Gastrointest Endosc . 1988;34:113–117
  36. Yoshida H, Mamada Y, Taniai N, Yamamoto K, Kawano Y, Mizuguchi Y, et al  A randomized controlled trial of bimonthly versus biweekly endoscopic variceal ligation of esophageal varices . Am J Gastroenterol . 2005;100:2005–2009
  37. Villanueva C, Minyana J, Ortiz J, Gallego A, Soriano G, Torras X, et al  Endoscopic ligation compared with combined treatment with nadolol and isosorbide mononitrate to prevent recurrent variceal rebleeding . N Engl J Med . 2001;345:647–655
  38. Lo GH, Chen WC, Chen MH, Hsu PI, Lin CK, Tsai WL, et al. A prospective, randomized trial of endoscopic variceal ligation versus nadolol and isosorbide mononitrate for the prevention of esophageal variceal rebleeding . Gastroenterology . 2002;123:728–734
  39. Patch D, Sabin CA, Goulis J, Gerunda G, Greenslade L, Merkel C, et al. A randomized, controlled trial of medical therapy versus endoscopic ligation for the prevention of variceal rebleeding in patients with cirrhosis . Gastroenterology . 2002;123:1013–1019
  40. Romero G, Kravetz D, Argonz J, Vulcano C, Suarez A, Fassio E, et al  Nadolol plus isosorbide mononitrate compared with banding plus low volume sclerotherapy for prevention of variceal rebleeding in patients with cirrhosis . Hepatology . 2004;40:204
  41. Garcia-Pagan JC , Bosch J . Endoscopic band ligation in the treatment of portal hypertension . NCP Gastroenterol Hepatol . 2005;2:526–535
  42. Lo GH , Lai KH , Cheng JS , Huang RL , Wang SJ , Chiang HT . Prevalence of paraesophageal varices and gastric varices in patients achieving variceal obliteration by banding ligation and by injection sclerotherapy . Gastrointest Endosc . 1999;49:428–436
  43. Singh P , Pooran N , Indaram A , Bank S . Combined ligation and sclerotherapy versus ligation alone for secondary prophylaxis of esophageal variceal bleeding: a meta-analysis . Am J Gastroenterol . 2002;97:623–629
  44. Lo GH, Lai KH, Cheng JS, Lin CK, Huang JS, Hsu PI, et al  The additive effect of sclerotherapy to patients receiving repeated endoscopic variceal ligation: a prospective, randomized trial . Hepatology . 1998;28:391–395
  45. Hou MC , Chen WC , Lin HC , Lee FY , Chang FY , Lee SD . A new “sandwich” method of combined endoscopic variceal ligation and sclerotherapy versus ligation alone in the treatment of esophageal variceal bleeding: a randomized trial . Gastrointest Endosc . 2001;53:572–578
  46. Cheng YS, Pan S, Lien GS, Suk FM, Wu MS, Chen JN, et al. Adjuvant sclerotherapy after ligation for the treatment of esophageal varices: a prospective, randomized long-term study . Gastrointest Endosc . 2001;53:566–571
  47. Sharara AI , Rockey DC . Gastroesophageal variceal hemorrhage . N Engl J Med . 2001;345:669–681
  48. Hou MC, Lin HC, Chen CH, Kuo BIT, Perng CL, Lee FY, et al. Changes in portal hypertensive gastropathy after endo-scopic variceal sclerotherapy or ligation: an endoscopic observation . Gastrointest Endosc . 1995;42:139–144
  49. Lo GH, Lai KH, Cheng JS, Hsu PI, Chen TA, Wang EM, et al  The effects of endoscopic variceal ligation and pro-pranolol on portal hypertensive gastropathy: a prospective, controlled trial . Gastrointest Endosc . 2001;53:579–584
  50. Sarin SK , Lahoti D , Saxena SP , Murthi NS , Makwane UK . Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients . Hepatology . 1992;16:1343–1349
  51. Korula J , Ralls P . The effect of chronic endoscopic sclerotherapy on portal pressure in cirrhotics . Gastroenterology . 1991;101:800–805
  52. Lo GH, Liang HL, Lai KH, Chang CF, Hwu JH, Chen SM, et al  The impact of endoscopic variceal ligation on the pressure of the portal venous system . J Hepatol . 1996;24:74–80
  53. Lo GH , Lai KH , Lee SD , Tsai YT , Lo KJ . Does propranolol maintain post-sclerotherapy variceal obliteration? A prospective randomized study . J Gastroenterol Hepatol . 1993;8:358–362
  54. Lo GH, Lai KH, Cheng JS, Chen MH, Huang HC, Hsu PI, et al. Endoscopic variceal ligation plus nadolol and sucral-fate compared with ligation alone for the prevention of variceal rebleeding: a prospective, randomized trial . Hepatology . 2000;32:461–465
  55. de la Pena J, Brullet E, Sanchez-Hernandez E, Rivero M, Vergara M, Martin-Lorente JL, et al  Variceal ligation plus nadolol compared with ligation for prophylaxis of variceal rebleeding: a multicenter trial . Hepatology . 2005;41:572–578
  56. Lo GH , Chen WC , Chen MH , Lai KH . A randomized, controlled trial of banding ligation plus drug therapy vs. drug therapy alone in the prevention of esophageal variceal rebleeding . Endoscopy . 2005;37:78
  57. Garcia-Pagan JC, Villaneuva C, Albillos A, Banares R, Planas R, Casado M, et al. Nadolol +isosorbide-5-mononitrate (NAD +ISMN) vs. NAD +ISMN+endoscopic band ligation in the prevention of rebleeding in patients with cirrhosis. Preliminary results of a multicenter RCT . J Hepatol . 2006;2:11
  58. Garcia-Tsao G . Current management of the complications of cirrhosis and portal hypertension: variceal hemorrhage, ascites, and spontaneous bacterial peritonitis . Gastroenterology . 2001;120:726–748
  59. Bosch J , Garcia-Pagan JC . Prevention of variceal rebleeding . Lancet . 2003;361:952–954
  60. Boyer TD . Pharmacologic treatment of portal hypertension: past, present, and future . Hepatology . 2001;34:834–839
  61. Yang CF, Tzeng WS, Chang JM, Liang HL, Huang JS, Pan HB, et al  Experience with transjugular intrahepatic portosystemic shunts for gastroesophageal variceal bleeding . J Chin Med Assoc . 1996;57:204–213
  62. Papatheodoridis G , Goulis J , Leandro G , Patch D , Burroughs AK . Transjugular intrahepatic portosystemic shunt compared with endoscopic treatment for prevention of variceal rebleeding: a meta-analysis . Hepatology . 1999;30:612–622
  63. Angermayr B, Cejna M, Koenig F, Karnel F, Hackl F, Gangl A, et al  Survival in patients undergoing transjugular intrahepatic portosystemic shunt: ePTFE-covered stent grafts versus bare stents . Hepatology . 2003;38:1043–1050
  64. Boyer TD , Haskal ZJ . The role of transjugular intrahepatic portosystemic shunt in the management of portal hypertension . Hepatology . 2005;41:386–400
  65. Chen WC , Lo GH , Lai KH , Cheng JS , Hsu PI , Lin CK . Development of hepatocellular carcinoma after successful management of esophageal variceal bleeding . J Chin Med Assoc . 2004;67:557–564

PII: S1726-4901(09)70328-4

doi: 10.1016/S1726-4901(09)70328-4

Journal of the Chinese Medical Association
Volume 69, Issue 12 , Pages 553-560 , December 2006

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