Correlation between diameter of esophageal varices and early rebleeding following endoscopic variceal ligation: a multicenter retrospective study based on artificial intelligence-based endoscopic virtual rule
作者：Chuankun Cao, Jing Jin, Rui Cai, Yuan Chu, Kaichun Wu, Zuo Wang, Ting Xiao, Heng Zhang, Hongfei Huang, Heng Liu, Qianqian Zhang, Xuecan Mei, Derun Kong · 发表于：Frontiers in Medicine · 年份：2024 · DOI：10.3389/fmed.2024.1406108 · 被引用次数：10 · 研究领域：Liver Disease and Transplantation、Gastrointestinal Bleeding Diagnosis and Treatment、Hepatocellular Carcinoma Treatment and Prognosis
Background and objective Bleeding following endoscopic variceal ligation (EVL) may occur as a result of numerous factors, including a diameter of esophageal varices (EV) that is too large to be completely ligated. The present study aimed to develop an artificial intelligence-based endoscopic virtual ruler (EVR) to measure the diameter of EV with a view to finding more suitable cases for EVL. Methods The present study was a multicenter retrospective study that included a total of 1,062 EVLs in 727 patients with liver cirrhosis with EV, who underwent EVL from April 2016 to March 2023. Patients were divided into early rebleeding ( n = 80) and non-rebleeding groups ( n = 982) according to whether postoperative bleeding occurred at 6 weeks. The characteristics of patient baseline data, the status of rebleeding at 6 weeks after surgery and the survival status at 6 weeks after rebleeding were analyzed. Results The early rebleeding rate following 1,062 EVL procedures was 7.5%, and the mortality rate at 6 weeks after bleeding was 16.5%. Results of the one-way binary logistic regression analysis demonstrated that the risk factors for early rebleeding following EVL included: high TB ( P = 0.009), low Alb ( P = 0.001), high PT ( P = 0.004), PVT ( P = 0.026), HCC ( P = 0.018), high Child-Pugh score ( P < 0.001), Child-Pugh grade C( P < 0.001), high MELD score( P = 0.004), Japanese variceal grade F3 ( P < 0.001), diameter of EV ( P < 0.001), and number of ligatu...