Primary prophylaxis of variceal bleeding in cirrhotics unable to take β-blockers: A randomized trial of ligation

C. Triantos, J. Vlachogiannakos, A. Armonis, A. Saveriadis, A. Kougioumtzian, G. Leandro, S. Manolakopoulos, D. Tzourmakliotis, S. A. Raptis, A. K. Burroughs, A. Avgerinos

Research output: Contribution to journalArticle

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Abstract

Aim: To compare endoscopic banding ligation vs. no treatment in cirrhotics with intolerance or contraindications to β-blockers for prevention of first bleeding in portal hypertension. Methods: A sample size of 214 was planned with all sizes of varices. However, the trial was stopped due to increased bleeding in 52 patients in the ligation group. The baseline severity liver disease and endoscopic features were similar. Ligation group: 25 (M/F = 21/4, mean age: 60 ± 9.37 years); 27 not-treated group: 27 (M/F = 17/10, mean age: 63 ± 10.27). Results: The mean follow-up period was 19.5 ± 13.3 months: five bled in the ligation group (20%), three from varices (two after banding at 11 and 17 days; one during the procedure), and two from gastropathy; two bled in the not-treated group (7% - two both varices) (P = 0.24). There were seven deaths in the ligation group and 11 in the not-treated group (P = 0.39). Conclusion: Sixty per cent of the bleeding in the banding group was probably iatrogenic, requiring the study to be stopped. Endoscopic banding ligation was no better than no treatment. This study suggests that ligation may be harmful when used as primary prophylaxis, similar to prophylactic sclerotherapy in the past.

Original languageEnglish
Pages (from-to)1435-1443
Number of pages9
JournalAlimentary Pharmacology and Therapeutics
Volume21
Issue number12
DOIs
Publication statusPublished - Jun 15 2005

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Ligation
Hemorrhage
Varicose Veins
Sclerotherapy
Portal Hypertension
Sample Size
Liver Diseases
Therapeutics

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Primary prophylaxis of variceal bleeding in cirrhotics unable to take β-blockers : A randomized trial of ligation. / Triantos, C.; Vlachogiannakos, J.; Armonis, A.; Saveriadis, A.; Kougioumtzian, A.; Leandro, G.; Manolakopoulos, S.; Tzourmakliotis, D.; Raptis, S. A.; Burroughs, A. K.; Avgerinos, A.

In: Alimentary Pharmacology and Therapeutics, Vol. 21, No. 12, 15.06.2005, p. 1435-1443.

Research output: Contribution to journalArticle

Triantos, C, Vlachogiannakos, J, Armonis, A, Saveriadis, A, Kougioumtzian, A, Leandro, G, Manolakopoulos, S, Tzourmakliotis, D, Raptis, SA, Burroughs, AK & Avgerinos, A 2005, 'Primary prophylaxis of variceal bleeding in cirrhotics unable to take β-blockers: A randomized trial of ligation', Alimentary Pharmacology and Therapeutics, vol. 21, no. 12, pp. 1435-1443. https://doi.org/10.1111/j.1365-2036.2005.02457.x
Triantos, C. ; Vlachogiannakos, J. ; Armonis, A. ; Saveriadis, A. ; Kougioumtzian, A. ; Leandro, G. ; Manolakopoulos, S. ; Tzourmakliotis, D. ; Raptis, S. A. ; Burroughs, A. K. ; Avgerinos, A. / Primary prophylaxis of variceal bleeding in cirrhotics unable to take β-blockers : A randomized trial of ligation. In: Alimentary Pharmacology and Therapeutics. 2005 ; Vol. 21, No. 12. pp. 1435-1443.
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AU - Triantos, C.

AU - Vlachogiannakos, J.

AU - Armonis, A.

AU - Saveriadis, A.

AU - Kougioumtzian, A.

AU - Leandro, G.

AU - Manolakopoulos, S.

AU - Tzourmakliotis, D.

AU - Raptis, S. A.

AU - Burroughs, A. K.

AU - Avgerinos, A.

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