Journal of Gastrointestinal & Digestive System
Open Access

Abstract

bleed, bleed-related mortality, and all-cause mortality. Among 601 patients in 5 homogeneous trials comparing prophylactic ligation with untreated controls, relative risks of first variceal bleed, bleed-related mortality, and all-cause mortality were 0.36 (0.26- 0.50), 0.20 (0.11-0.39), and 0.55 (0.43-0.71), with respective NNTs of 4.1, 6.7, and 5.3. Among 283 subjects from 4 trials comparing ligation with ��-blocker therapy, the relative risk of first variceal bleed was 0.48 (0.24- 0.96), with NNT of 13; however, there was no effect on either bleed-related mortality (relative risk [RR], 0.61; confidence interval [CI], 0.20-1.88) or all-cause mortality (RR, 0.95; CI, 0.56-1.62). In conclusion, compared with untreated controls, prophylactic ligation reduces the risks of variceal bleeding and mortality. Compared with ��-blockers, ligation reduces the risk for first variceal bleed but has no effect on mortality. Prophylactic ligation should be considered for patients with large esophageal varices who cannot tolerate ��-blockers. Subsequent research should further compare ligation and ��-blockers to determine the effect on mortality, and measure ligation�s cost-effectiveness

Biography

Dr. Balwant Singh Gill has completed his MD from Dr.MGR Medical University in 2011 and DNB from Delhi from NBE in 2014. He is the Director & Head of Institute of Liver, Gastroenterology & Pancreatico Biliary Sciences, SGRD HOSPITAL (India) an advanced Endoscopy Center. He has published more than 5 papers in reputed journals and has been serving as a consultant Gastroenterologist, Hepatologist & Interventional Endoscopist at their center of gastroenterology from July 2015