Evidence map›Paper›PMID 33133373›Full record

ArticleWorld journal of gastrointestinal endoscopy2020

Defining the advantages and exposing the limitations of endoscopic variceal ligation in controlling acute bleeding and achieving complete variceal eradication.

Jake Krige, Eduard Jonas, Urda Kotze, Christo Kloppers, Karan Gandhi, Hisham Allam, Marc Bernon, Sean Burmeister, Mashiko Setshedi

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of gastrointestinal endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
1.0field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 16 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Jake KrigeDepartments of Surgery and Medicine, University of Cape Town Health Sciences Faculty, Cape Town 7925, South Africa.
Eduard JonasDepartments of Surgery and Medicine, University of Cape Town Health Sciences Faculty, Cape Town 7925, South Africa.
Urda KotzeDepartments of Surgery and Medicine, University of Cape Town Health Sciences Faculty, Cape Town 7925, South Africa.
Christo KloppersDepartments of Surgery and Medicine, University of Cape Town Health Sciences Faculty, Cape Town 7925, South Africa.
Karan GandhiDepartments of Surgery and Medicine, University of Cape Town Health Sciences Faculty, Cape Town 7925, South Africa.
Hisham AllamDepartments of Surgery and Medicine, University of Cape Town Health Sciences Faculty, Cape Town 7925, South Africa.
Marc BernonDepartments of Surgery and Medicine, University of Cape Town Health Sciences Faculty, Cape Town 7925, South Africa.
Sean BurmeisterDepartments of Surgery and Medicine, University of Cape Town Health Sciences Faculty, Cape Town 7925, South Africa.
Mashiko SetshediDepartments of Surgery and Medicine, University of Cape Town Health Sciences Faculty, Cape Town 7925, South Africa.
University of Cape Town · ZA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBleeding esophageal varices (BEV) is a potentially life-threatening complication in patients with portal hypertension with mortality rates as high as 25% within six weeks of the index variceal bleed. After control of the initial bleeding episode patients should enter a long-term surveillance program with endoscopic intervention combined with non-selective β-blockers to prevent further bleeding and eradicate EV.

aimTo assess the efficacy of endoscopic variceal ligation (EVL) in controlling acute variceal bleeding, preventing variceal recurrence and rebleeding and achieving complete eradication of esophageal varices (EV) in patients who present with BEV.

methodsA prospectively documented single-center database was used to retrospectively identify all patients with BEV who were treated with EVL between 2000 and 2018. Control of acute bleeding, variceal recurrence, rebleeding, eradication and survival were analyzed using Baveno assessment criteria.

resultsOne hundred and forty patients (100 men, 40 women; mean age 50 years; range, 21-84 years; Child-Pugh grade A = 32; B = 48; C = 60) underwent 160 emergency and 298 elective EVL interventions during a total of 928 endoscopy sessions. One hundred and fourteen (81%) of the 140 patients had variceal bleeding that was effectively controlled during the index banding procedure and never bled again from EV, while 26 (19%) patients had complicated and refractory variceal bleeding. EVL controlled the acute sentinel variceal bleed during the first endoscopic intervention in 134 of 140 patients (95.7%). Six patients required balloon tamponade for control and 4 other patients rebled in hospital. Overall 5-d endoscopic failure to control variceal bleeding was 7.1% (

conclusionEVL was highly effective in controlling the sentinel variceal bleed with an overall 5-day failure to control bleeding of 7.1%. Although repeated EVL achieved complete variceal eradication in less than half of patients with BEV, of whom 62% recurred, there was a significant reduction in subsequent rebleeding.

Indexed as

EndoscopyEsophageal varicesSecondary prophylaxisVariceal bleedingVariceal ligationVariceal recurrence

Identifiers

PMID33133373
PMCPMC7579524
OpenAlexW3094300694

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.