Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. May 28, 2026; 32(20): 116260
Published online May 28, 2026. doi: 10.3748/wjg.v32.i20.116260
Published online May 28, 2026. doi: 10.3748/wjg.v32.i20.116260
Comparative safety and efficacy of endoscopic band ligation and variceal obturation for gastric varices: Systematic review and meta-analysis
Usama Tufail, Aleena Ihtasham, Fahad Amin, Muhammad Talha Khan, Amna Iman, Ahtisam Akbar Khan, Department of Medicine, King Edward Medical University, Lahore 54000, Punjab, Pakistan
Eman Khalid, Department of Medicine, Cairo University, Cairo 12613, Al Qahirah, Egypt
Fazia Khattak, Department of Medicine, Khyber Medical College, Peshawar 25120, Khyber Pakhtunkhwa, Pakistan
Taha Alam, Department of Medicine, Dow University of Health Sciences, Karachi 54600, Sindh, Pakistan
Eeman Afroz, Department of Medicine, Allama Iqbal Medical College, Lahore 54000, Punjab, Pakistan
Hina Aslam, Department of Medicine, Karachi Metropolitan University, Karachi 74700, Sindh, Pakistan
Tooba Fida, Department of Medicine, ISMMS/Valley Health, Paramus, NJ 07652, United States
Iman Osman Abufatima, Department of Medicine, University of Medical Sciences and Technology, Khartoum 11111, Sudan
Author contributions: Tufail U designed the study, was responsible for data curation and formal analysis, developed the methodology, and drafted and revised the manuscript; Khalid E contributed to data curation, formal analysis, and drafting and revision of the manuscript; Iman A contributed to data curation, methodology development, and drafting and revision of the manuscript; Amin F, Talha Khan M, Khattak F, Aslam H, and Afroz E contributed to data curation and drafting and revision of the manuscript; Khan AA, Alam T, Ihtasham A and Osman Abufatima I contributed to drafting and revision of the manuscript; Fida T supervised the study and contributed to drafting and revision of the manuscript; all authors reviewed and approved the final version of the manuscript.
AI contribution statement: We have used Grammarly AI to refine language, improve grammar, clarity, and readability of the manuscript. We have used AI tools only for language polishing and writing assistance at the level of grammar and readability.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Iman Osman Abufatima, MD, Doctor, Department of Medicine, University of Medical Sciences and Technology, El Riyad area, Square No. 13, Khartoum 11111, Sudan. drimanadam03@gmail.com
Received: November 7, 2025
Revised: December 29, 2025
Accepted: February 25, 2026
Published online: May 28, 2026
Processing time: 195 Days and 10.9 Hours
Revised: December 29, 2025
Accepted: February 25, 2026
Published online: May 28, 2026
Processing time: 195 Days and 10.9 Hours
Core Tip
Core Tip: This meta-analysis of seven randomized controlled trials establishes that while endoscopic variceal ligation (EVL) and endoscopic variceal obturation (EVO) achieve similar initial hemostasis rates for gastric varices, EVO demonstrates superior long-term durability. Specifically, cyanoacrylate injection significantly reduces the risk of rebleeding compared to EVL without increasing overall mortality. These findings support prioritizing cyanoacrylate as the first-line intervention for gastric variceal hemorrhage, reserving EVL as an alternative only when resources for obturation are unavailable.