title: Efficacy of vasopressin/terlipressin and somatostatin/octreotide for the prevention of early variceal rebleeding after the initial control of bleeding: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Our purpose was to conduct a meta-analysis to compare the effectiveness of vasopressin/terlipressin and somatostatin/octreotide on variceal re-bleeding within and after 5 days of initial control bleeding.
  
  
  METHODS
  A search was conducted of PubMed, the Cochrane database, and Google Scholar until June 31, 2014 using combinations of the search terms: esophageal varices, variceal re-bleeding, recurrent variceal hemorrhage, early re-bleeding, vasopressin, somatostatin, terlipressin, octreotide. Inclusion criteria were: (1) randomized controlled trials, (2) patients with esophageal or esophageal and gastric varices confirmed by endoscopy, (3) re-bleeding control was evaluated, (4) treatment with somatostatin/vasopressin. Outcome measures were the re-bleeding rates within 5 days (≤ 5 days) or after 5 days (>5 days) after initial treatment.
  
  
  RESULTS
  Six studies were included in the analysis. Five studies had complete data of re-bleeding rate within 5 days after initial treatment, and the combined odds ratio (OR) of 0.87 [95% confidence interval (CI) 0.51, 1.50] indicated that there was no difference in the re-bleeding rate between patients treated with vasopressin/terlipressin or somatostatin/octreotide. Two studies had complete data of the re-bleeding rate 5 days after initial treatment, and the combined OR of 1.12 (95% CI 0.64, 1.95) indicated there was no difference in the re-bleeding rate between patients who were treated with vasopressin/terlipressin or somatostatin/octreotide.
  
  
  CONCLUSIONS
  There is no difference between vasopressin/terlipressin and somatostatin/octreotide in prevention of re-bleeding after the initial treatment of bleeding esophageal varices.
authors: Department of General Surgery, Tongji Hospital, Tongji Medical College, Science and Technology of Huazhong University, No. 1095 Liberation Avenue, Wuhan, 430030, China, wangchao75@163.com.
authors: Chao
authors: C
authors: Wang
authors: Juan
authors: J
authors: Han
authors: Liang
authors: L
authors: Xiao
authors: Chang-E
authors: CE
authors: Jin
authors: Dong-Jian
authors: DJ
authors: Li
authors: Zhen
authors: Z
authors: Yang
mesh_terms: D004932:Esophageal and Gastric Varices / Q000150:complications*; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008236:Lypressin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015282:Octreotide / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D055502:Secondary Prevention / Q000379:methods*; D000077585:Terlipressin; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
chemical_list: D005765:Gastrointestinal Agents; D014662:Vasoconstrictor Agents; D008236:Lypressin; D000077585:Terlipressin; D015282:Octreotide