Prospects for treatment of esophageal varices considering the safety of endoscopic band ligation

Excerpt

In this issue, Pfisterer et al. described the current treatment strategy for esophageal varices. They showed that 2.6% of patients had procedure-related bleeding (PRB) within 30 days after initial endoscopic band ligation (EBL). Of the 16 patients (2.6%) who experienced PRB, 9 (1.5%) bled within 14 days and 6 (37.5%) had bleeding-related deaths. Risk factors associated with PRB showed a trend toward higher risk with higher MELD (OR: 1.07). In particular, serum bilirubin level was a high risk factor for PRB in both univariate and multivariate analyses. Furthermore, there was a trend toward higher bleeding rates in patients with higher serum bilirubin levels of 2 mg/dL or more (HR: 2.62). Patients with a PT-INR greater than 1.5 did not have a higher risk of PRB in univariate analysis (OR: 1.10). …