Endoscopic variceal ligation compared with endoscopic injection sclerotherapy for treatment of esophageal variceal hemorrhage: a meta-analysis.
OBJECTIVE
To compare the effect of endoscopic variceal ligation (EVL) with that of endoscopic injection sclerotherapy (EIS) in the treatment of patients with esophageal variceal bleeding.


METHODS
We performed a systematic literature search of multiple online electronic databases. Meta-analysis was conducted to evaluate risk ratio (RR) and 95% confidence interval (CI) of combined studies for the treatment of patients with esophageal variceal bleeding between EVL and EIS.


RESULTS
Fourteen studies comprising 1236 patients were included in the meta-analysis. The rebleeding rate in actively bleeding varices patients in the EVL group was significantly lower than that in the EIS group (RR=0.68, 95%CI: 0.57-0.81). The variceal eradication rate in actively bleeding varices patients in the EVL group was significantly higher than that in the EIS group (RR=1.06, 95%CI: 1.01-1.12). There was no significant difference about mortality rate between the EVL group and EIS group (RR=0.95, 95%CI: 0.77-1.17). The rate of complications in actively bleeding varices patients in the EVL group was significantly lower than that in the EIS group (RR=0.28, 95%CI: 0.13-0.58).


CONCLUSIONS
Our meta-analysis has found that EVL is better than EIS in terms of the lower rates of rebleeding, complications, and the higher rate of variceal eradication. Therefore, EVL is the first choice for esophageal variceal bleeding.
Cong Dai, Wei-Xin Liu, Min Jiang, Ming-Jun Sun, Department of Gastroenterology, First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning Province, China.
Cong
C
Dai
Cong Dai, Wei-Xin Liu, Min Jiang, Ming-Jun Sun, Department of Gastroenterology, First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning Province, China.
Wei-Xin
WX
Liu
Cong Dai, Wei-Xin Liu, Min Jiang, Ming-Jun Sun, Department of Gastroenterology, First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning Province, China.
Min
M
Jiang
Cong Dai, Wei-Xin Liu, Min Jiang, Ming-Jun Sun, Department of Gastroenterology, First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning Province, China.
Ming-Jun
MJ
Sun
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D004932:Esophageal and Gastric Varices / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D015552:Injections, Intralesional; D008026:Ligation; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018579:Patient Selection; D012307:Risk Factors; D012597:Sclerosing Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D015911:Sclerotherapy / Q000009:adverse effects / Q000401:mortality; D016896:Treatment Outcome
D012597:Sclerosing Solutions
Endoscopic injection sclerotherapy; Endoscopic variceal ligation; Esophageal variceal bleeding; Meta-analysis; Rebleeding; Variceal eradication