Meta-Analysis
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2015; 21(8): 2534-2541
Published online Feb 28, 2015. doi: 10.3748/wjg.v21.i8.2534
Endoscopic variceal ligation compared with endoscopic injection sclerotherapy for treatment of esophageal variceal hemorrhage: A meta-analysis
Cong Dai, Wei-Xin Liu, Min Jiang, Ming-Jun Sun
Cong Dai, Wei-Xin Liu, Min Jiang, Ming-Jun Sun, Department of Gastroenterology, First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning Province, China
Author contributions: Dai C and Liu WX carried out the literature search, selection, validity assessment, data abstraction and data analysis; Dai C and Jiang M wrote the paper and incorporated the comments from other authors and peer reviewers; Dai C and Sun MJ had the original idea for the paper, formulated the protocol and contributed to data abstraction and analysis; all authors reviewed and approved the final draft of the paper.
Supported by National Natural Science Foundation of China, No. 81300273.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ming-Jun Sun, Professor, Department of Gastroenterology, First Affiliated Hospital, China Medical University, 92 Beier Road, Heping District, Shenyang 110001, Liaoning Province, China. 273159833@qq.com
Telephone: +86-24-23414369 Fax: +86-24-23414369
Received: May 17, 2014
Peer-review started: May 17, 2014
First decision: June 10, 2014
Revised: June 20, 2014
Accepted: August 28, 2014
Article in press: August 28, 2014
Published online: February 28, 2015
Processing time: 287 Days and 0.7 Hours
Abstract

AIM: To compare the effect of endoscopic variceal ligation (EVL) with that of endoscopic injection sclerotherapy (EIS) in the treatment of patients with esophageal variceal bleeding.

METHODS: We performed a systematic literature search of multiple online electronic databases. Meta-analysis was conducted to evaluate risk ratio (RR) and 95% confidence interval (CI) of combined studies for the treatment of patients with esophageal variceal bleeding between EVL and EIS.

RESULTS: Fourteen studies comprising 1236 patients were included in the meta-analysis. The rebleeding rate in actively bleeding varices patients in the EVL group was significantly lower than that in the EIS group (RR = 0.68, 95%CI: 0.57-0.81). The variceal eradication rate in actively bleeding varices patients in the EVL group was significantly higher than that in the EIS group (RR = 1.06, 95%CI: 1.01-1.12). There was no significant difference about mortality rate between the EVL group and EIS group (RR = 0.95, 95%CI: 0.77-1.17). The rate of complications in actively bleeding varices patients in the EVL group was significantly lower than that in the EIS group (RR = 0.28, 95%CI: 0.13-0.58).

CONCLUSION: Our meta-analysis has found that EVL is better than EIS in terms of the lower rates of rebleeding, complications, and the higher rate of variceal eradication. Therefore, EVL is the first choice for esophageal variceal bleeding.

Keywords: Esophageal variceal bleeding; Endoscopic variceal ligation; Endoscopic injection sclerotherapy; Rebleeding; Variceal eradication; Meta-analysis

Core tip: We performed a meta-analysis to evaluate risk ratio and 95% confidence interval (CI) of combined studies for the treatment of patients with esophageal variceal bleeding between endoscopic variceal ligation (EVL) and endoscopic injection sclerotherapy (EIS). Our meta-analysis has found that EVL is better than EIS in terms of the lower rates of rebleeding, complications, and the higher rate of variceal eradication. Therefore, EVL is the first choice for esophageal variceal bleeding.