Bleeding From Band Ligation–induced Ulcers Following the Treatment of Esophageal Varices

作者：Zixuan Hu, Shaojun Liu, Tao Liu, Wei Zhu, Jiake Li · 发表于：Journal of Clinical Gastroenterology · 年份：2021 · DOI：10.1097/mcg.0000000000001618 · 被引用次数：14 · 研究领域：Liver Disease and Transplantation、Gastrointestinal Bleeding Diagnosis and Treatment、Gastroesophageal reflux and treatments

GOAL: Our study aimed to explore the incidence of bleeding from ulcers due to premature band slippage and to identify possible associated factors. BACKGROUND: Band ligation (BL) plays a vital role in treating esophageal varices; however, the procedure carries a considerable risk of band slippage, variceal site ulcer formation, and posttreatment bleeding. MATERIALS AND METHODS: We retrospectively reviewed the records of patients with esophageal varices who underwent endoscopic hemostasis by BL at our institution between 2015 and 2020. We statistically compared the patients with post-BL ulcer bleeding and those without (controls). The outcome variable was the development of BL-induced ulcer bleeding. The patients' demographics, clinical, and laboratory parameters, and BL procedure parameters were independent variables. Univariate followed by a multivariate logistic regression were performed to identify possible associated factors from the odds ratio (OR). RESULTS: Of the 4579 eligible patients, 388 (8.5%) presented with post-BL ulcer bleeding. The presence of high-risk stigmata indicated a 1.271 times higher risk of bleeding [95% confidence interval (CI):1.018-1.587], and a greater number of varices was associated with an increased risk of post-BL ulcer bleeding [OR=1.184 (95% CI: 1.073-1.307)]. Conversely, the use of fewer bands per variceal site was associated with fewer bleeding incidents [OR=1.308 (95% CI: 1.090-1.569)]. Univariate analysis identified proton pump inhibitor ...