scholarly journals Carvedilol for prevention of variceal bleeding: a systematic review and meta analysis

2019 ◽  
Author(s):  
Konstantinos Malandris
Keyword(s):  
Systematic Review ◽  
Variceal Bleeding ◽  
Meta Analysis

scholarly journals Short-course vasoconstrictors are adequate for esophageal variceal bleeding after endoscopic variceal ligation: A systematic review and meta-analysis

2021 ◽  
Vol 104 (3) ◽  
pp. 003685042110317
Author(s):  
Jen-Hao Yeh ◽  
Gin-Ho Lo ◽  
Ru-Yi Huang ◽  
Chih-Wen Lin ◽  
Wen-Lun Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Failure ◽  
Variceal Bleeding ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Endoscopic Variceal Ligation ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Short Course ◽  
Significant Difference

Endoscopic variceal ligation (EVL) with vasoconstrictors has been recommended for acute esophageal variceal bleeding. However, the optimal duration of vasoconstrictors after EVL is controversial. This systematic review and meta-analysis was conducted to explore the efficacy of short-course vasoconstrictors (≤3 days) versus standard combination (3–5 days). A comprehensive literature review was conducted using the PubMed, Embase, and Cochrane library databases with subsequent meta-analysis. The primary outcomes were 5-day rebleeding, mortality, and treatment failure rates. A risk ratio (RR) with 95% confidence interval is used for outcome comparison. Nine randomized studies with 838 patients were included. The initial hemostasis (96.8% vs 97.4%, p = 0.919), 5-day rebleeding (11.2% vs 8.3%, RR = 1.05, 95% CI = 0.62–1.76), mortality (0 vs 1.3%, RR = 0.48, 95% CI = 0.10–2.39), and treatment failure (7.4% vs 5.9%, RR = 1.10, 95% CI = 0.48–2.49) were similar in both groups. Subgroup analysis suggested EVL alone had no significant difference of 5-day re-bleeding (15.9% vs 7.1%, RR = 2.25, 95% CI = 0.87–5.77), mortality (0 vs 0.7%, RR = 0.71, 95% CI = 0.08–6.03), treatment failure (9.6% vs 6.7%, RR = 1.43, 95% CI = 0.54–3.75) compared to standard combination. Clinical heterogeneity was found for the rebleeding rate for the subgroup during sensitivity analysis. EVL with short-course vasoconstrictors is highly efficacious for esophageal variceal bleeding. Further studies are required to determine the genuine need of subsequent vasoconstrictor after successful EVL.

scholarly journals Mo1531 – Early (Pre-Emptive) Tips Versus Conventional Treatment for Prophylaxis of Esophageal Variceal Bleeding: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 156 (6) ◽  
pp. S-1333-S-1334
Author(s):  
Shadi Hamdeh ◽  
Osama Altayar ◽  
Muhammad Aziz ◽  
Jihan Fathallah ◽  
Mojtaba S. Olyaee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Variceal Bleeding ◽  
Conventional Treatment ◽  
Meta Analysis ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding

Balloon Tamponade and Esophageal Stenting for Esophageal Variceal Bleeding in Cirrhosis: A Systematic Review and Meta-analysis

2019 ◽  
Vol 39 (02) ◽  
pp. 178-194 ◽  
Author(s):  
Susana Rodrigues ◽  
Andrés Cárdenas ◽  
Àngels Escorsell ◽  
Jaime Bosch
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Variceal Bleeding ◽  
Meta Analysis ◽  
Medium Term ◽  
Short Term ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Balloon Tamponade ◽  
Acute Variceal Bleeding

AbstractFailure to control variceal bleeding with current recommendations occurs in 10 to 20% of cases. This systematic review and meta-analysis analyzes the experience, results, and complications of “bridge” therapies for failure to control acute variceal bleeding: balloon tamponade and esophageal stents. The main outcomes assessed were failure to control bleeding and mortality in the short-term and medium-term follow-up, and adverse events. Balloon tamponade studies had a pooled rate of short-term failure to control bleeding of 35.5%, and adverse events in over 20% of cases; 9.7% resulting in death. Stenting failed to control bleeding in the short term and medium term in 12.7 and 21.5% of cases of severe or refractory variceal bleeding, respectively, despite stent migration in 23.8% of cases. Medium-term mortality rates were similar in both therapies. Although only one trial compared these treatments, the available evidence consistently supports that stents serve as a better and safer bridge therapy in refractory acute variceal bleeding.

Secondary Prophylaxis of Gastric Variceal Bleeding: A Systematic Review and Network Meta‐analysis

2021 ◽  
Author(s):  
Karim T. Osman ◽  
Tarek Nayfeh ◽  
Ahmed M. Abdelfattah ◽  
Khaled Alabdallah ◽  
Bashar Hasan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Variceal Bleeding ◽  
Meta Analysis ◽  
Secondary Prophylaxis
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