Abstract | BACKGROUND & AIMS: METHODS: All EVLs performed at a tertiary Italian Center from 2009 to 2016 were retrospectively reviewed. Patients treated with LMWH were classified as on- LMWH; the remaining as no- LMWH. Endoscopic characteristics at first and index EVL (that preceding an endoscopy either showing a bleeding episode or the absence of further treatable varices) and clinical events within 4 weeks from the procedures were recorded. RESULTS AND CONCLUSIONS: Five hundred fifty-three EVLs were performed in 265 patients (in 215 as a primary prophylaxis): 169 EVLs in 80 on- LMWH and 384 in 185 no- LMWH (4.9 ± 1.1 vs 4.8 ± 1.0 bands/session, respectively; P = .796). Six patients bled (2.2%) without between-groups difference (3.8% on- LMWH vs 1.6% no- LMWH, Log-rank P = .291). Large varices with red marks (100% vs 51.4%, P = .032), number of bands (5.6 ± 0.5 vs 4.6 ± 1.2, P = .004), underlying portal vein thrombosis (66.7% vs 23.6%, P = .033), and creatinine (2.2 ± 2.7 vs 1.0 ± 0.8 mg/dL, P = .001) at index EVL were significantly different between bleeders and non-bleeders. Six patients died within 4-week from index EVL, without between-groups difference (2.5% on- LMWH vs 2.2% no- LMWH, Log-rank P = .863). LMWH does not increase the risk of post-procedural bleeding and does not affect survival of cirrhotic patients undergoing prophylactic EVL.
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Authors | Marcello Bianchini, Giulia Cavani, Ambra Bonaccorso, Laura Turco, Francesco Vizzutti, Alessandro Sartini, Stefano Gitto, Alberto Merighi, Federico Banchelli, Erica Villa, Filippo Schepis |
Journal | Liver international : official journal of the International Association for the Study of the Liver
(Liver Int)
Vol. 38
Issue 7
Pg. 1253-1262
(07 2018)
ISSN: 1478-3231 [Electronic] United States |
PMID | 29469184
(Publication Type: Journal Article)
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Copyright | © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. |
Chemical References |
- Heparin, Low-Molecular-Weight
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Topics |
- Aged
- Esophageal and Gastric Varices
(prevention & control)
- Esophagoscopy
- Female
- Gastrointestinal Hemorrhage
(epidemiology, etiology)
- Heparin, Low-Molecular-Weight
(therapeutic use)
- Humans
- Italy
(epidemiology)
- Ligation
(adverse effects)
- Liver Cirrhosis
(complications, mortality, therapy)
- Male
- Middle Aged
- Retrospective Studies
- Survival Analysis
- Tertiary Care Centers
- Treatment Outcome
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