title: A Prospective Randomized Study on the Risk of Bacteremia in Banding versus Sclerotherapy of Esophageal Varices.
abstract: BACKGROUND
  Esophageal variceal banding may be less likely to cause bacteremia than sclerotherapy. The existing data about the frequency of bacteremia after esophageal variceal banding are conflicting, and few studies include both banding and sclerotherapy.
  
  
  OBJECTIVE
  We conducted a prospective randomized controlled trial to compare the frequency of bacteremia after esophageal variceal banding and sclerotherapy.
  
  
  METHODS
  Over a 2-year period, patients with liver disease admitted for upper gastrointestinal bleeding or for outpatient elective variceal therapy were enrolled. New patients were randomized preprocedure to either banding or sclerotherapy, and subsequent sessions utilized the initial procedure. The groups consisted of banding, sclerotherapy, and endoscopy without variceal therapy. Subjects underwent endoscopy by one out of three gastroenterologists. Blood cultures were obtained 5 min before and 30 min after endoscopy to check for bacteremia.
  
  
  RESULTS
  Postendoscopic blood cultures were positive following 4 out of 139 (2.9%) sessions: 1 sclerotherapy and 3 control sessions. All postendoscopic positive blood cultures were found following emergency sessions (4/92, 4.3%). One pre-endoscopic blood culture was positive in a patient with emergency banding. The rates of positive postendoscopic blood cultures among groups with emergency banding (0/22, 0%), emergency sclerotherapy (1/41, 2.3%), and emergency control (3/29, 10.3%) were not significantly different. Postendoscopic positive blood cultures were not found after elective sessions with either banding or sclerotherapy.
  
  
  CONCLUSIONS
  Postendoscopic bacteremia was infrequent following emergency endoscopy in patients with esophageal variceal bleeding. Bacteremia was not found after esophageal variceal banding, although this was not significantly less frequent than after sclerotherapy. Postendoscopic bacteremia was not associated with elective variceal therapy.
authors.affiliation: Division of Gastroenterology, Texas Tech University Health Sciences Center , El Paso, Texas , USA.
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Zuckerman
authors.affiliation: Division of Gastroenterology, Texas Tech University Health Sciences Center , El Paso, Texas , USA.
authors.forename: Yi
authors.initials: Y
authors.lastname: Jia
authors.affiliation: Division of Gastroenterology, Texas Tech University Health Sciences Center , El Paso, Texas , USA.
authors.forename: Jesus A
authors.initials: JA
authors.lastname: Hernandez
authors.affiliation: Division of Gastroenterology, Texas Tech University Health Sciences Center , El Paso, Texas , USA.
authors.forename: Venkateswara R
authors.initials: VR
authors.lastname: Kolli
authors.affiliation: Division of Gastroenterology, Texas Tech University Health Sciences Center , El Paso, Texas , USA.
authors.forename: Arturo
authors.initials: A
authors.lastname: Norte
authors.affiliation: Division of Gastroenterology, Texas Tech University Health Sciences Center , El Paso, Texas , USA.
authors.forename: Hemal
authors.initials: H
authors.lastname: Amin
authors.affiliation: Division of Gastroenterology, Texas Tech University Health Sciences Center , El Paso, Texas , USA.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Casner
authors.affiliation: Division of Biostatistics and Epidemiology, Texas Tech University Health Sciences Center , El Paso, Texas , USA.
authors.forename: Alok
authors.initials: A
authors.lastname: Dwivedi
authors.affiliation: Division of Infectious Disease, Texas Tech University Health Sciences Center , El Paso, Texas , USA.
authors.forename: Hoi
authors.initials: H
authors.lastname: Ho
keywords: bacteremia; banding; cirrhosis; esophageal varices; sclerotherapy