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Evidence summaries

Band Ligation for Primary Prevention of Upper Gastrointestinal Bleeding in Adults with Cirrhosis and Oesophageal Varices

In patients with cirrhosis, band ligation of oesophageal varices reduces mortality, upper gastrointestinal bleeding, variceal bleeding, and serious adverse events compared to no intervention. Level of evidence: "A"

Summary

A Cochrane review [Abstract] 1 included 6 studies with a total of 637 subjects. Included participants had cirrhosis and oesophageal varices with no previous history of variceal bleeding. Seventy-one of 320 participants allocated to band ligation compared to 129 of 317 participants allocated to no intervention died (RR 0.55, 95% CI 0.43 to 0.70; NNTTB = 6 persons). In addition, band ligation was associated with reduced risks of upper gastrointestinal bleeding (RR 0.44, 95% CI 0.28 to 0.72; 6 trials, 637 participants; NNTTB = 5 persons), serious adverse events (RR 0.55, 95% CI 0.43 to 0.70; 6 trials, 637 participants; NNTTB = 4 persons), and variceal bleeding (RR 0.43, 95% CI 0.27 to 0.69; 6 trials, 637 participants; NNTTB = 5 persons).

The non-serious adverse events reported in association with band ligation included oesophageal ulceration, dysphagia, odynophagia, retrosternal and throat pain, heartburn, and fever. No trials reported on health-related quality of life.

Links

SOF table http://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012673.pub2/full#CD012673-sec1-0001

Abstract in McMaster database

Clinical comments

Note

Date of latest search:

References

  • Vadera S, Yong CWK, Gluud LL et al. Band ligation versus no intervention for primary prevention of upper gastrointestinal bleeding in adults with cirrhosis and oesophageal varices. Cochrane Database Syst Rev 2019;(6):CD012673. [PubMed]

Primary/Secondary Keywords