Original Research

Endoscopic Band Ligation vs Pharmacological Therapy or Both as Secondary Prophylaxis for Esophageal Variceal Bleeding in Chronic Liver Disease Patients

Muhammad Farooq1
District Headquarter Hospital, Multan
Zafar Niaz2
King Edward Medical University, Lahore
Sami Ullah Mumtaz2
King Edward Medical University, Lahore
Ali Asad Khan2
King Edward Medical University, Lahore
Somia Iqtadar2
King Edward Medical University, Lahore
Sajid Abaidullah2
King Edward Medical University, Lahore

✉ Correspondence: Sami Ullah Mumtaz Email: drsummumtaz@gmail.com

DOI https://doi.org/10.70302/jpsim.v2i3.2147
Volume: 2, Issue 3 Pages: 205–208 Published: 20 Sep 2021
Received: 21 Jun 2021 Accepted: 13 Aug 2021 Published Online: 20 Sep 2021

Abstract

Objective

To compare beta blocker, endoscopic variceal band ligation (EVBL) and combination of both for prevention of re-bleeding of esophageal varices in chronic liver disease (CLD) patients.

Methods

This was a randomized controlled trial done at North Medical ward, Mayo hospital, Lahore for 6 months. After ethical approval, 320 patients of ages 18-80 years with either gender admitted with variceal bleed were included in study. After stabilizing with standard treatment of EVBL & beta blocker, patients were randomly divided in four groups, i.e. group I was put on propranolol, group II had EVBL every 2 weekly, group III had EVBL every 4 weekly and group IV had combination of 2 weekly EVBL with beta blocker. All patients were followed for six months. Quantitative variables in four groups were compared by ANOVA test whereas qualitative variables by chi-square test.

Results

After 6 months follow up re-bleeding was noted in 10 patients after one month (8 in group I, 2 in group II while no patient rebleed in group III and group IV). 61 (19.06%) patients rebleed after 3 months (40/7/14/0). 107 (33.43%) patients rebleed after 6 months (73/16/18/0 respectively). Significantly more re-bleeding occurred in group I patients whereas no rebleed occurred in group IV patients. No significant difference was noted in group II and III. Overall 7 patients lost the follow up.

Conclusion

Combination of beta blocker with EVBL is more effective than EVBL and beta blocker alone in secondary prophylaxis of variceal bleeding in CLD patients.

Keywords
Beta-Blocker Variceal Bleed EVBL CLD Secondary prophylaxis.

How to Cite This Article

Farooq M, Niaz Z, Mumtaz SU, Khan AA, Iqtadar S, Abaidullah S. Endoscopic Band Ligation vs Pharmacological Therapy or Both as Secondary Prophylaxis for Esophageal Variceal Bleeding in Chronic Liver Disease Patients. J Pak Soc Intern Med. 2021;2(3):205–208. doi:10.70302/jpsim.v2i3.2147

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Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

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Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2021 Journal of Pakistan Society of Internal Medicine.
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