Endoscopic variceal ligation versus endoscopic variceal sclerotherapy in treatment of esophageal variceal bleeding:a meta-analysis / 中国内镜杂志

ABSTRACT

Objective To make a systematical review of the efficacy and safety of endoscopic variceal ligation versus endoscopic variceal sclerotherapy for treatment of esophageal variceal bleeding. Methods We electronically searched databases including PubMed, Web of Science, The Cochrane Library (Issue 2, 2016), CNKI, WanFang Data and from Jan., 1980, to Mar., 2015, collected randomized controlled trials (RCTs) about EVL versus EVS for the patients of esophageal variceal bleeding. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 24 studies including 2020 patients were included. The results of meta-analysis showed that, there were no signiifcant differences in the variceal eradication rate (RR=1.04, 95%CI 0.99 to 1.09, P=0.090) between the EVL group and the EVS group; Compared with the EVS group, the EVL group could significantly reduce the rate of variceal rebleeding (RR=0.69, 95%CI 0.59 to 0.81, P=0.000), the rate of mortality (RR=0.76, 95%CI 0.63 to 0.90, P=0.002) and the rate of complication (RR=0.41, 95%CI 0.26 to 0.63, P=0.000), but the rate of variceal recurrent rate of EVS group was lower than that of the EVL group (RR=1.67, 95%CI 1.40 to 2.01,P=0.000). Conclusion Current evidence shows that, the variceal eradication rate between EVL and EVS is similar, but the EVL has less incidence of variceal rebleeding and mortality and complication.