Evidence map›Paper›PMID 39542889›Full record

ArticleSurgical endoscopy2025

Comparative efficacy of endoscopic variceal ligation versus non-selective beta-blockers in primary prevention of gastroesophageal varix type 2: an IPTW-adjusted study.

Linxiang Liu, Shenfeng Ye, Yuan Nie, Xuan Zhu

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. 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

4 authors.

Linxiang LiuDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Jiangxi Medical College, Digestive Disease Hospital, The First Affiliated Hospital, Nanchang University, No.17, Yongwaizhengjie Road, Donghu District, Nanchang, 330006, Jiangxi, China.
Shenfeng YeDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Jiangxi Medical College, Digestive Disease Hospital, The First Affiliated Hospital, Nanchang University, No.17, Yongwaizhengjie Road, Donghu District, Nanchang, 330006, Jiangxi, China.
Yuan NieDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Jiangxi Medical College, Digestive Disease Hospital, The First Affiliated Hospital, Nanchang University, No.17, Yongwaizhengjie Road, Donghu District, Nanchang, 330006, Jiangxi, China.
Xuan ZhuDepartment of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Jiangxi Medical College, Digestive Disease Hospital, The First Affiliated Hospital, Nanchang University, No.17, Yongwaizhengjie Road, Donghu District, Nanchang, 330006, Jiangxi, China. ndyfy00326@ncu.edu.cn.

Funding

National Natural Science Foundation of China 81960120National Natural Science Foundation of China 82360131Postgraduate Innovation Special Foundation of Jiangxi Province YC2023-B058
6 · The paper itself

Abstract

backgroundPractice guidelines recommend non-selective beta-blockers (NSBB) and endoscopic variceal ligation (EVL) for primary prevention in cirrhosis patients with esophageal varices. However, there is no clear recommendation for primary prevention strategies for gastric varices, particularly GOV-2. Our objective is to investigate the incidence of initial bleeding and liver-related complications when NSBB and EVL are used for primary prevention in GOV-2.

methodsA retrospective analysis was conducted on data from patients with GOV-2 gastric varices. Patients were divided into the NSBB group or the EVL group. Differences in the incidence of initial bleeding within 1 year, as well as the occurrence of complications such as hepatic encephalopathy and ascites, were compared between the two groups before and after adjustment for Inverse Probability of Treatment Weighting (IPTW). A Cox proportional hazards model was used to identify independent risk factors for the first bleeding event.

resultsThere were 60 patients in the NSBB group and 66 patients in the EVL group. Before IPTW adjustment, there were differences between the two groups in sex, portal hypertensive gastropathy, esophageal variceal diameter, red signs, FIB-4, and MELD scores. After IPTW adjustment, these differences were balanced, with standardized mean differences (SMDs) within acceptable ranges. Kaplan-Meier survival analysis showed no difference in bleeding rates between the two groups before or after IPTW adjustment. After IPTW adjustment, Cox regression analysis identified esophageal variceal diameter (HR:5.59 (2.03-15.39), p < 0.001) and MELD score (HR:1.17 (1.01-1.23), p = 0.042) were independent risk factors for bleeding. NSBB treatment did not reduce the incidence of liver-related complications within one year compared to EVL.

conclusionFor primary prevention of bleeding in cirrhotic patients with GOV-2, EVL does not significantly reduce initial bleeding episodes or liver-related complications compared to NSBB.

Indexed as

Adrenergic beta-AntagonistsEsophageal and Gastric VaricesGastrointestinal HemorrhagePrimary PreventionAgedEndoscopy, GastrointestinalFemaleHumansLigationLiver CirrhosisMaleMiddle AgedRetrospective StudiesTreatment OutcomeAdrenergic beta-AntagonistsCirrhosisEndoscopic variceal ligationGastric varicesNon-selective beta-blockersPrimary prevention

Identifiers

PMID39542889

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Registered trials

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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.