Number of endoscopic sessions to eradicate varices identifies high risk of rebleeding in cirrhotic patients

BMC Gastroenterology

Xixuan Wang¹  Xiaoping Zou¹  Yi Wang¹  Huiwen Guo¹  Feng Zhang¹  Xiaochun Yin¹  Na Zhang¹  Jiangqiang Xiao¹  Ming Zhang¹  Lihong Gu¹  Yang Cheng¹  Yuzheng Zhuge¹ 

[1] Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School;

关键词: Number;    Endoscopic therapy;    Variceal rebleeding;   

DOI  :  10.1186/s12876-022-02283-0

来源: DOAJ

【 摘 要 】

Abstract Background and aims Risk stratification to identify patients with high risk of variceal rebleeding is particularly important in patients with decompensated cirrhosis. In clinical practice, eliminating gastroesphageal varices thoroughly after sequential endoscopic treatment reduces the rebleeding rate, however, no simple method has been build to predict high risk of variceal rebleeding. We conducted this study to explore the value of the number of endoscopic sessions required to eradicate gastroesphageal varices in identifying high risk of rebleeding. Patients and methods Consecutive cirrhotic patients received sequential endoscopic therapy between January 2015 and March 2020 were enrolled. Endoscopic treatment was performed every 1–4 weeks until the eradication of varices. The primary endpoint was variceal rebleeding. Results A total of 146 patients were included of which 60 patients received standard therapy and 86 patients underwent sequential endoscopic treatment alone. The cut-off value of the number of sequential endoscopic sessions is 3.5 times. Variceal rebleeding was significant higher in patients with endoscopic sessions > 3 times versus ≤ 3 times (61.5% vs. 17.5%, p < 0.001). Variceal rebleeding of patients with endoscopic sessions ≤ 3 times was significant lower than patients with > 3 times in group of standard therapy (19.6% vs. 88.9%, p < 0.001) and endoscopic therapy (15.9% vs. 47.1%, p = 0.028) respectively. Conclusion The number of sequential endoscopic sessions required to eradicate the varices is related to the risk of variceal rebleeding in patients with cirrhosis. If three times of endoscopic treatment can not eradicate the varices, a more aggressive treatment such as TIPS should be seriously considered.

【 授权许可】

Unknown