Evidence map›Paper›PMID 34446612›Full record

ArticleGut and liver2022

Minimal and Maximal Extent of Band Ligation for Acute Variceal Bleeding during the First Endoscopic Session.

Jang Han Jung, Jung Hyun Jo, Sung Eun Kim, Chang Seok Bang, Seung In Seo, Chan Hyuk Park, Se Woo Park

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

Article in Gut and liver, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 37% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Guideline
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  3. Article
  4. Article
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

7 authors at 6 institutions in 1 country.

Jang Han JungDivision of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.ORCID https://orcid.org/0000-0001-7875-2868
Jung Hyun JoDivision of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.ORCID https://orcid.org/0000-0002-2641-8873
Sung Eun KimDivision of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.ORCID https://orcid.org/0000-0001-6236-780X
Chang Seok BangDivision of Gastroenterology, Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.ORCID https://orcid.org/0000-0003-4908-5431
Seung In SeoDivision of Gastroenterology, Department of Internal Medicine, Gangdong Sacred Heart Hospital, Seoul, Korea.ORCID https://orcid.org/0000-0003-4417-0135
Chan Hyuk ParkDepartment of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.ORCID https://orcid.org/0000-0003-3824-3481
Se Woo ParkDivision of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.ORCID https://orcid.org/0000-0003-1603-7468
Hallym University Dongtan Sacred Heart Hospital · KRHallym University · KRHallym University Sacred Heart Hospital · KRHanyang University Guri Hospital · KRKangdong Sacred Heart Hospital · KRYonsei University · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

aimsThe appropriate number of band ligations during the first endoscopic session for acute variceal bleeding is debatable. We aimed to compare the technical aspects of endoscopic variceal ligation (EVL) in patients with variceal bleeding according to the number of bands placed per session.

methodsWe retrospectively reviewed multicenter data from patients who underwent EVL for acute variceal bleeding. Patients were classified into minimal EVL (targeting only the foci with active bleeding or stigmata of recent bleeding) and maximal EVL (targeting potential bleeding sources in addition to the aforementioned targets) groups. The primary endpoint was 5-day treatment failure. The secondary endpoints were 30-day rebleeding, 30-day mortality, and intraprocedural adverse events.

resultsMinimal EVL was associated with lower rates of hypoxia and shock during EVL than maximal EVL (hypoxia, 0.9% vs 2.9%; shock, 1.3% vs 3.4%). However, treatment failure was higher in the minimal EVL group than in the maximal EVL group (odds ratio, 1.60; 95% confidence interval, 1.06 to 2.41). Age ≥60 years, Model for End-Stage Liver Disease score ≥15, Child-Turcotte-Pugh classification C, presence of hepatocellular carcinoma, and systolic blood pressure <90 mm Hg at initial presentation were also associated with treatment failure. In contrast, 30-day rebleeding and 30-day mortality did not differ between the minimal and maximal EVL groups.

conclusionsGiven that minimal EVL was associated with a high risk of treatment failure, maximal EVL may be a better option for variceal bleeding. However, the minimal EVL strategy should be considered in select patients because it does not affect 30-day rebleeding and mortality.

Indexed as

End Stage Liver DiseaseEsophageal and Gastric VaricesGastrointestinal HemorrhageHumansLiver CirrhosisMiddle AgedRetrospective StudiesSeverity of Illness IndexBand ligationEndoscopic hemostasisEsophageal and gastric varicesGastrointestinal hemorrhageLiver cirrhosis

Identifiers

PMID34446612
PMCPMC8761925
OpenAlexW3195320432

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.