Evaluation of bleeding from band ligation-induced ulcers following esophageal varices therapy

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Created On: 08/11/2021

Evaluation of bleeding from band ligation-induced ulcers following esophageal varices therapy

This retrospective case-control analysis was carried out to determine the occurrence of bleeding from ulcers as a result of premature band slippage and for identifying the possible related factors.

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Key take away

In people with esophageal varices, the overall occurrence of post-band ligation ulcer bleeding was 8.5%. High-risk stigmata, greater number of varices, and more use of bands per variceal site were linked with a raised risk of post-band ligation bleeding.

Background

This retrospective case-control analysis was carried out to determine the occurrence of bleeding from ulcers as a result of premature band slippage and for identifying the possible related factors.

Method

The records of people having esophageal varices who underwent endoscopic hemostasis by band ligation were retrospectively reviewed. People having post-band ligation ulcer bleeding and people without post-band ligation ulcer bleeding (controls) were statistically compared. The major endpoint was the development of band ligation-stimulated ulcer bleeding.

The independent variables included participants' demographics, lab, and clinical parameters, and band ligation procedure parameters. The univariate followed by multivariate logistic regression was carried out for identifying the possible linked factors from the odds ratio (OR).

Result

Notably, 8.5% of participants (388/4579) presented with post-band ligation ulcer bleeding. The existence of high-risk stigmata showed a 1.271 times elevated risk of bleeding, and an elevated number of varices was linked with a raised risk of post-band ligation ulcer bleeding [OR=1.184].

Contrarily, the usage of reduced bands per variceal site was linked with minimized incidences of bleeding (OR=1.308). The proton pump inhibitors were found to be protective in the univariate assessment (OR=0.770).

Conclusion

The risk of post-band ligation bleeding is increased by factors like high-risk stigmata, greater number of varices, and higher use of bands per variceal site.