Endoscopic varices ligation vs. β-blocker for primary prophylaxis of varices bleeding: a Meta-analysis

doi:10.3877/cma.j.issn.2095-2015.2017.03.006

Abstract

Abstract:

Objective

To evaluate the efficacy of endoscopic varices ligation(EVL)andβ-blocker for prophylaxis of oesophageal-gastric varices bleeding.

Methods

PubMed/Medicine, Chinese biomedical literature service system and other databases were searched for relevant clinical randomized controlled trials about EVL andβ-blocker for prophylaxis of oesophageal-gastric varices bleeding published before April 2016.Two authors independently assessed study quality and extracted data.Stata12.0 software was used to statistically analyze the data.

Results

Fourteen studies including 1 441 cases were included.This Meta-analysis results were as follows: bleeding rate for the first time: EVL vs.propranolol(RR=0.78, 95% CI: 0.59-1.03, I²=11%, P=0.34), EVL vs.carvedilol(RR=1.54, 95% CI: 0.69-3.42, I²=38.8%, P=0.20); bleeding related mortality: EVL vs.propranolol(RR=0.83, 95% CI: 0.52-1.34, I²=0%, P=0.954), EVL vs.carvedilol(RR=0.84, 95% CI: 0.29-2.46, I²=0%, P=0.770); total mortality: EVL vs.propranolol(RR=1.08, 95% CI: 0.88-1.32, I²=0%, P=0.837), EVL vs.carvedilol(RR=0.91, 95% CI: 0.58-1.42, I²=25.2%, P=0.248); adverse effects rate: EVL vs.β-blocker(RR=1.19, 95% CI: 0.81-1.77, I²=87.3%, P=0).

Conclusions

There are no significant differences on preventing for the primary varices bleeding in first bleeding rate, bleeding related mortality, total mortality and adverse effects rate between EVL andβ-blocker.But considering the cost and compliance, we recommend the best choice for preventing on the primary bleeding isβ-blocker.

Key words: Esophageal and gastric varices, Endoscopic varices ligation, β-receptor blocker, Propranolol, Carvedilol, Prevention

Wei Zhang, Zhaotao Tian, Yunliang Cui. Endoscopic varices ligation vs. β-blocker for primary prophylaxis of varices bleeding: a Meta-analysis[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2017, 07(03): 118-124.

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References 26

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