Letter to the Editor: Beta‐Blockers Are Preferable to Banding Ligation for Primary Prophylaxis of Variceal Bleeding?

Hepatology ◽  
2019 ◽  
Vol 70 (5) ◽  
pp. 1876-1876
Author(s):  
Gin‐Ho Lo
Keyword(s):  
Variceal Bleeding ◽  
Beta Blockers ◽  
Primary Prophylaxis ◽  
Letter To The Editor ◽  
Banding Ligation

Banding ligation versus beta-blockers for primary prophylaxis of oesophageal variceal bleeding in children

2013 ◽  
Author(s):  
Juan Cristóbal Gana ◽  
Lorena I Cifuentes ◽  
Jaime Cerda ◽  
Luis A Villarroel del Pino ◽  
Alfredo Peña ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Beta Blockers ◽  
Primary Prophylaxis ◽  
Banding Ligation

scholarly journals Meta-analysis: beta-blockers versus banding ligation for primary prophylaxis of esophageal variceal bleeding

2012 ◽  
Vol 11 (3) ◽  
pp. 369-383 ◽  
Author(s):  
Natalie Funakoshi ◽  
Yohan Duny ◽  
Jean-Christophe Valats ◽  
Frédérique Ségalas-Largey ◽  
Nicolas Flori ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Beta Blockers ◽  
Meta Analysis ◽  
Primary Prophylaxis ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Banding Ligation

scholarly journals Primary prophylaxis of variceal bleeding in cirrhotics unable to take beta-blockers: a randomized trial of ligation

2005 ◽  
Vol 21 (12) ◽  
pp. 1435-1443 ◽  
Author(s):  
C. Triantos ◽  
J. Vlachogiannakos ◽  
A. Armonis ◽  
A. Saveriadis ◽  
A. Kougioumtzian ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Variceal Bleeding ◽  
Beta Blockers ◽  
Primary Prophylaxis

scholarly journals Motion – Prophylactic Banding of Esophageal Varices Is Useful: Arguments against the Motion

2002 ◽  
Vol 16 (10) ◽  
pp. 693-695 ◽  
Author(s):  
Kris V Kowdley
Keyword(s):  
Esophageal Varices ◽  
Variceal Bleeding ◽  
Beta Blockers ◽  
Low Cost ◽  
Cost Effective ◽  
Primary Prophylaxis ◽  
Ease Of Use ◽  
Endoscopic Sclerotherapy ◽  
Variceal Hemorrhage ◽  
Band Ligation

Bleeding from esophageal varices leads to substantial morbidity and mortality. Despite advances in pharmacological and endoscopic therapy, as well as general supportive care, the mortality rate associated with acute variceal hemorrhage has not improved significantly over the past two decades. Prophylactic therapy with nonselective beta-blockers or long acting nitrates reduces the incidence of variceal bleeding in patients with cirrhosis, is cost effective and may improve survival. Surgical portosystemic shunting reduces the risk of bleeding but is associated with significant operative mortality and a high risk of portosystemic encephalopathy. Endoscopic sclerotherapy causes adverse effects in a large proportion of patients and is, therefore, not suitable for primary prophylaxis of bleeding. Although variceal band ligation is effective in reducing the rate of bleeding and is safer than sclerotherapy, it has not been shown to provide a survival advantage compared with beta-blockers. A significant reduction in the rate of variceal bleeding with band ligation, compared with beta-blockers, was shown in only one study. Beta-blockers offer several advantages, including low cost, ease of use and safety. The available data do not yet support the prophylactic use of variceal band ligation, and this procedure should be reserved for patients who are either unwilling or unable to take beta-blockers. It is hoped that additional large, multicentre trials of band ligation versus beta-blockers will examine the efficacy, cost effectiveness and impact on quality of life among patients with cirrhosis.

Sign in / Sign up

Export Citation Format

Share Document