Efficacy of endoscopic treatments for acute esophageal variceal bleeding in cirrhotic patients: systematic review and meta-analysis

Conclusions This study showed that ligation is superior to sclerotherapy, although with moderate heterogeneity. The combination of sclerotherapy and vasoactive drugs was more effective than sclerotherapy alone. Although current guidelines recommend combined use of ligation with vasoactive drugs in treatment of esophageal variceal bleeding, this study failed to demonstrate the superiority of this combined treatment. [...] © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  open access Full text
Source: Endoscopy International Open - Category: Gastroenterology Authors: Tags: Review Source Type: research

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In this study, we compared the bleeding risks following endoscopic biliary sphincterotomy (EST) vs EPBD in cirrhotic patients and identified clinical factors associated with bleeding and 30-day mortality. Taiwan's National Health Insurance Database was used to identify 3201 cirrhotic patients who underwent EST or EPBD between January 1, 2010, and December 31, 2013. We enrolled 2620 patients receiving EST and 581 patients receiving EPBD. The mean age was 63.1 ± 13.9 years, and 70.4% (2252/3201) were men. The incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) bleeding was higher among patien...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Conclusion: There are only a few treatment options available for patients with advanced HCC and severe liver damage. Multidisciplinary treatment such as locoregional treatments and prophylaxis of variceal bleeding may result in tumor downstaging, enabling radical liver transplantation without further exacerbation of liver damage.Case Rep Oncol 2019;12:289 –296
Source: Case Reports in Oncology - Category: Cancer & Oncology Source Type: research
​BY GREGORY TAYLOR, DO, &SHERIF EL-ALAYLI, DOA 60-year-old man with a significant history of alcohol abuse, metastatic hepatocellular carcinoma, and cirrhosis presented to the emergency department complaining of vomiting up bright red blood. The patient was reportedly supposed to have an esophagogastroduodenoscopy (EGD) six months earlier but failed to follow up.He had two episodes of melena the night before and two episodes of hematemesis that morning. He was also experiencing fatigue, weakness, and abdominal pain, which he described as achy and localized to the epigastric region. He had refused treatment for his he...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Authors: Ichikawa T, Machida N, Kaneko H, Oi I, A Fujino M Abstract Objective The aim of this study was to identify patients with a high risk of early mortality after acute esophageal variceal bleeding by measuring the C-reactive protein (CRP) level. Methods We retrospectively evaluated 154 consecutive cirrhotic patients admitted with esophageal variceal bleeding. Differences between categorical variables were assessed by the chi-square test. Continuous variables were compared using the Mann-Whitney U-test. Multivariate logistic regression analyses consisting of clinical laboratory parameters were performed to iden...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
In conclusion, we detected SB tube transection in a patient with hepatic encephalopathy and removed remnants of the inflated tube using endoscopic scissors. PMID: 30153725 [PubMed - as supplied by publisher]
Source: Clinical Endoscopy - Category: Gastroenterology Tags: Clin Endosc Source Type: research
We reported such a case which received liver transplantation (LT) after successful consecutive downstaging therapies. A 40 year-old man with alcohol related liver cirrhosis and repeated esophageal varices bleeding had HCC with tumor thrombi in right main portal vein and the second portal branch of segment VI (stage IIIB).
Source: Transplantation Proceedings - Category: Transplant Surgery Authors: Source Type: research
Conclusion: In cirrhotic patients, the presence of pleural effusion predicts poor long-term outcomes. Liver transplantation could dramatically improve the survival and should be suggested as soon as possible.
Source: The Saudi Journal of Gastroenterology - Category: Gastroenterology Authors: Source Type: research
Rationale: Inflammatory myofibroblastic tumor (IMT) is an uncommon mesenchymal neoplasm, and its presence in a grafted liver is exceedingly rare. Patient concerns: A 54-year-old woman was admitted to our hospital with a half-month history of intermittent melena. She had undergone deceased-donor liver transplantation (LT) for hepatitis B virus related liver cirrhosis without hepatocellular carcinoma 5 months previously. Diagnosis: Laboratory examination showed impaired liver and renal functions and Epstein–Barr virus (EBV) infection, but tumor markers within normal ranges. Gastroscopy showed esophageal varices...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
CONCLUSIONS: For patients with small HCC and concomitant EVB, MWA plus PCDV may reduce the incidence of postoperative complications relative to and provide similar therapeutic benefits as HR plus PCDV, especially for patients with low albumin levels. PMID: 27817240 [PubMed - as supplied by publisher]
Source: International Journal of Hyperthermia - Category: Internal Medicine Tags: Int J Hyperthermia Source Type: research
Abstract Statins are a class of molecules that inhibit HMG CoA reductase. They are usually prescribed as a lipid lowering medication. However, there is accumulating evidence that statins have multiple secondary effects both related and unrelated to their lipid-lowering effect. This narrative review of the literature aims to provide the reader with information from clinical studies related to the effect of statin and statins' potential use in patients with liver diseases. In patients with advanced liver disease due to any etiology, statins exhibit an antifibrotic effect possibly through the prevention of hepatic si...
Source: World Journal of Gastroenterology - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
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