WGO Graded Evidence: Treatment of Esophageal Varices

Level: Meta-analyses, Systematic reviews, Practice guidelines: 54 Abstracts

Legend:   : Special Mention  : Important  : Very Important  : Key Development
	American Gastroenterological Association Institute technical review on the management of gastric subepithelial masses. JH Hwang, SD Rulyak, MB Kimmey, American Gastroenterological Association Institute, Gastroenterology. 2006 Jun:2217-28
	Early administration of vapreotide for variceal bleeding in patients with cirrhosis. P Calès, C Masliah, B Bernard, PP Garnier, C Silvain, N Szostak-Talbodec, JP Bronowicki, D Ribard, D Botta-Fridlund, P Hillon, K Besseghir, D Lebrec, French Club for the Study of Portal Hypertension, N Engl J Med. 2001 Jan 4:23-8
	Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis. C Ripoll, R Groszmann, G Garcia-Tsao, N Grace, A Burroughs, R Planas, A Escorsell, JC Garcia-Pagan, R Makuch, D Patch, DS Matloff, J Bosch, Portal Hypertension Collaborative Group, Gastroenterology. 2007 Aug:481-8
	High prevalence of spontaneous portal-systemic shunts in persistent hepatic encephalopathy: a case-control study. O Riggio, C Efrati, C Catalano, F Pediconi, O Mecarelli, N Accornero, F Nicolao, S Angeloni, A Masini, L Ridola, AF Attili, M Merli, Hepatology. 2005 Nov:1158-65
	Ligation versus propranolol for the primary prophylaxis of variceal bleeding in cirrhosis. M Schepke, G Kleber, D Nurnberg, J Willert, L Koch, W Veltzke-Schlieker, C Hellerbrand, J Kuth, S Schanz, S Kahl, WE Fleig, T Sauerbruch, German Study Group for the Primary Prophylaxis of Variceal Bleeding, Hepatology. 2004 Jul:65-72
	A1166C angiotensin II type 1 receptor gene polymorphism may predict hemodynamic response to losartan in patients with cirrhosis and portal hypertension. S Sookoian, G Castaño, SI García, P Viudez, C González, CJ Pirola, Am J Gastroenterol. 2005 Mar:636-42
	ASGE Guideline: the role of endoscopy in the management of variceal hemorrhage, updated July 2005. W Qureshi, DG Adler, R Davila, J Egan, W Hirota, J Leighton, E Rajan, MJ Zuckerman, R Fanelli, J Wheeler-Harbaugh, TH Baron, DO Faigel, Standards of Practice Committee, Gastrointest Endosc. 2005 Nov:651-5
	Causes of portal venous thrombosis in cirrhotic patients: the role of genetic and acquired factors. A Mangia, MR Villani, G Cappucci, R Santoro, R Ricciardi, D Facciorusso, G Leandro, N Caruso, A Andriulli, Eur J Gastroenterol Hepatol. 2005 Jul:745-51
	Clinical analysis of gastroesophageal reflux after PEG. S Nishiwaki, H Araki, N Goto, Y Niwa, M Kubota, M Iwashita, N Onogi, H Hatakeyama, T Hayashi, T Maeda, K Saitoh, Gastrointest Endosc. 2006 Dec:890-6
	Effects of esophageal varice eradication on portal hypertensive gastropathy and fundal varices: a retrospective and comparative study. O Yuksel, S K&oeig;klu, M Arhan, OF Yolcu, I Ertu.rul, B Odemi_, E Altiparmak, B Sahin, Dig Dis Sci. 2006 Jan:27-30
	Hemodynamics after endoscopic submucosal injection of epinephrine in patients with nonvariceal upper gastrointestinal bleeding: a matter of concern. S von Delius, P Thies, A Umgelter, C Prinz, RM Schmid, W Huber, Endoscopy. 2006 Dec:1284-8
	Improved prognosis for patients hospitalized with esophageal varices in Sweden 1969-2002. K Stokkeland, L Brandt, A Ekbom, R Hultcrantz, Hepatology. 2006 Mar:500-5
	Improved prognosis of cirrhosis patients with esophageal varices and thrombocytopenia treated by endoscopic variceal ligation plus partial splenic embolization. K Ohmoto, N Yoshioka, Y Tomiyama, N Shibata, M Takesue, K Yoshida, M Kuboki, S Yamamoto, Dig Dis Sci. 2006 Feb:352-8
	Is banding ligation for primary prevention of variceal bleeding as effective as beta-blockers, and is it safe? C Triantos, J Vlachogiannakos, S Manolakopoulos, A Burroughs, A Avgerinos, Hepatology. 2006 Jan:196-7; discussion 197-8
	Liver stiffness measurement predicts severe portal hypertension in patients with HCV-related cirrhosis. F Vizzutti, U Arena, RG Romanelli, L Rega, M Foschi, S Colagrande, A Petrarca, S Moscarella, G Belli, AL Zignego, F Marra, G Laffi, M Pinzani, Hepatology. 2007 May:1290-7
	Meta-analysis: endoscopic variceal ligation for primary prophylaxis of oesophageal variceal bleeding. MS Khuroo, NS Khuroo, KL Farahat, YS Khuroo, AA Sofi, ST Dahab, Aliment Pharmacol Ther. 2005 Feb 15:347-61
	Pharmacological reduction of portal pressure and long-term risk of first variceal bleeding in patients with cirrhosis. J Turnes, JC Garcia-Pagan, JG Abraldes, M Hernandez-Guerra, A Dell'Era, J Bosch, Am J Gastroenterol. 2006 Mar:506-12
	Prediction of large esophageal varices in patients with cirrhosis of the liver using clinical, laboratory and imaging parameters. SK Sharma, R Aggarwal, J Gastroenterol Hepatol. 2007 Nov:1909-15
	Prognostic role of the initial portal pressure gradient reduction after TIPS in patients with cirrhosis. E Biecker, F Roth, J Heller, HH Schild, T Sauerbruch, M Schepke, Eur J Gastroenterol Hepatol. 2007 Oct:846-52
	The prevalence and risk factors associated with esophageal varices in subjects with hepatitis C and advanced fibrosis. AJ Sanyal, RJ Fontana, AM Di Bisceglie, JE Everhart, MC Doherty, GT Everson, JA Donovan, PF Malet, S Mehta, MY Sheikh, AE Reid, MG Ghany, DR Gretch, Halt-C Trial Group, Gastrointest Endosc. 2006 Dec:855-64
	What are the risk factors for aggravation of esophageal varices in patients with hepatocellular carcinoma? K Kadouchi, K Higuchi, M Shiba, H Okazaki, K Yamamori, E Sasaki, K Tominaga, T Watanabe, Y Fujiwara, N Oshitani, T Arakawa, J Gastroenterol Hepatol. 2007 Feb:240-6
	Balloon-occluded retrograde transvenous obliteration improves liver function in patients with cirrhosis and portal hypertension. Y Miyamoto, K Oho, M Kumamoto, A Toyonaga, M Sata, J Gastroenterol Hepatol. 2003 Aug:934-42
	Characteristics, prognosis and outcome of patients with oesophageal varices in a university hospital in Sweden 1994-1999. SA Gunnarsdottir, R Olsson, ES Bj&oeig;rnsson, Scand J Gastroenterol. 2005 Dec:1462-8
	Cost-effectiveness analysis of variceal ligation vs. beta-blockers for primary prevention of variceal bleeding. TF Imperiale, RW Klein, N Chalasani, Hepatology. 2007 Apr:870-8
	Endoscopic Doppler US probe for the diagnosis of gastric varices (with videos). RC Wong, FT Farooq, A Chak, Gastrointest Endosc. 2007 Mar:491-6
	Endoscopic therapy for bleeding esophageal varices improves the outcome of Child C cirrhotic patients. S Hori, A Takaki, H Okada, A Fujiwara, R Takenaka, C Makidono, Y Shiratori, J Gastroenterol Hepatol. 2006 Nov:1704-9
	Esophageal capsule endoscopy in patients refusing conventional endoscopy for the study of suspected esophageal pathology. A Sánchez-Yague, A Caunedo-Alvarez, JM García-Montes, J Romero-Vázquez, FJ Pellicer-Bautista, JM Herrerías-Gutiérrez, Eur J Gastroenterol Hepatol. 2006 Sep:977-83
	Esophageal capsule endoscopy versus esophagogastroduodenoscopy for evaluating portal hypertension: a prospective comparative study of performance and tolerance. MG Lapalus, J Dumortier, F Fumex, S Roman, M Lot, B Prost, F Mion, T Ponchon, Endoscopy. 2006 Jan:36-41
	Fatal multiple systemic embolisms after injection of cyanoacrylate in bleeding gastric varices of a patient who was noncirrhotic but with idiopathic portal hypertension. G Saracco, C Giordanino, N Roberto, D Ezio, T Luca, S Caronna, P Carucci, W De Bernardi Venon, C Barletti, M Bruno, C De Angelis, A Musso, A Repici, R Suriani, M Rizzetto, Gastrointest Endosc. 2007 Feb:345-7
	Pleuropulmonary complications of esophageal variceal sclerotherapy with absolute alcohol. PK Sethy, R Kochhar, D Behera, DK Bhasin, K Raja, K Singh, J Gastroenterol Hepatol. 2003 Aug:910-4
	Prognosis in patients with cirrhosis and mild portal hypertension. H Ytting, S Møller, JH Henriksen, K Larsen, F Bendtsen, Scand J Gastroenterol. 2006 Dec:1446-53
	Racial disparities in the management of hospitalized patients with cirrhosis and complications of portal hypertension: a national study. GC Nguyen, DL Segev, PJ Thuluvath, Hepatology. 2007 May:1282-9
	Review article: recent advances in the management of bleeding gastric varices. D Tripathi, JW Ferguson, G Therapondos, JN Plevris, PC Hayes, Aliment Pharmacol Ther. 2006 Jul 1:1-17
	Sclerotherapy for gastric fundal variceal bleeding: is complete obliteration possible without cyanoacrylate? K Kojima, H Imazu, M Matsumura, Y Honda, N Umemoto, H Moriyasu, T Orihashi, M Uejima, C Morioka, Y Komeda, M Uemura, H Yoshiji, H Fukui, J Gastroenterol Hepatol. 2005 Nov:1701-6
	The budget impact of endoscopic screening for esophageal varices in cirrhosis. BM Spiegel, E Esrailian, G Eisen, Gastrointest Endosc. 2007 Oct:679-92
	The use of self-expanding metal stents to treat acute esophageal variceal bleeding. R Hubmann, G Bodlaj, M Czompo, L Benk&oeig;, P Pichler, S Al-Kathib, P Kiblb&oeig;ck, A Shamyieh, G Biesenbach, Endoscopy. 2006 Sep:896-901
	The use of transjugular intrahepatic portosystemic stent shunt in the management of acute oesophageal variceal haemorrhage. NC McAvoy, PC Hayes, Eur J Gastroenterol Hepatol. 2006 Nov:1135-41
	Transabdominal gastroesophageal devascularization without transection for bleeding varices: results and indicators of prognosis. N Goyal, D Singhal, S Gupta, AS Soin, S Nundy, J Gastroenterol Hepatol. 2007 Jan:47-50
	Transjugular intrahepatic portosystemic stent-shunt in the management of gastric and ectopic varices. D Tripathi, R Jalan, Eur J Gastroenterol Hepatol. 2006 Nov:1155-60
	Treatment of bleeding gastric varices. PG Northup, SH Caldwell, J Gastroenterol Hepatol. 2005 Nov:1631-3
Supplementary evidence:
	Changing compliance to the American College of Gastroenterology guidelines for the management of variceal hemorrhage: a regional survey. A Zaman, RJ Hapke, K Flora, HR Rosen, KG Benner, Am J Gastroenterol. 2004 Apr:645-9
	Combination endoscopic band ligation and sclerotherapy compared with endoscopic band ligation alone for the secondary prophylaxis of esophageal variceal hemorrhage: a meta-analysis. HA Karsan, SC Morton, PG Shekelle, BM Spiegel, MJ Suttorp, MA Edelstein, IM Gralnek, Dig Dis Sci. 2005 Feb:399-406
	Combined ligation and sclerotherapy versus ligation alone for secondary prophylaxis of esophageal variceal bleeding: a meta-analysis. P Singh, N Pooran, A Indaram, S Bank, Am J Gastroenterol. 2002 Mar:623-9
	Combined therapy for secondary prophylaxis of variceal rebleeding? D Maldonado, JS Barkin, Am J Gastroenterol. 2002 Aug:2134-6
	Cost of treatment of oesophageal variceal bleeding in patients with cirrhosis in France: results of a French survey. D Thabut, M Hammer, Y Cai, N Carbonell, Eur J Gastroenterol Hepatol. 2007 Aug:679-86
	Emergency sclerotherapy versus vasoactive drugs for variceal bleeding in cirrhosis: a Cochrane meta-analysis. G D'Amico, G Pietrosi, I Tarantino, L Pagliaro, Gastroenterology. 2003 May:1277-91
	Endoscopic screening for varices in cirrhotic patients: data from a national endoscopic database. M Kovalak, J Lake, N Mattek, G Eisen, D Lieberman, A Zaman, Gastrointest Endosc. 2007 Jan:82-8
	Endoscopic treatment versus endoscopic plus pharmacologic treatment for acute variceal bleeding: a meta-analysis. R Bañares, A Albillos, D Rincón, S Alonso, M González, L Ruiz-del-Arbol, M Salcedo, LM Molinero, Hepatology. 2002 Mar:609-15
	Evidence-based medicine (EBM) in practice: agreement between observers rating esophageal varices: how to cope with chance? F Sierra, A Cárdenas, Am J Gastroenterol. 2007 Nov:2363-6
	First meta-analysis of octreotide for variceal bleeding. A lost opportunity. G D'Amico, J Hepatol. 2002 Apr:574-7
	Meta-analysis of trials for variceal bleeding. G D'amico, V Criscuoli, D Fili, F Mocciaro, L Pagliaro, Hepatology. 2002 Oct:1023-4; author reply 1024-5
	Sclerosing agents for use in GI endoscopy. Technology Assessment Committee, J Croffie, L Somogyi, R Chuttani, J DiSario, J Liu, D Mishkin, RJ Shah, W Tierney, LM Wong Kee Song, BT Petersen, Gastrointest Endosc. 2007 Jul:1-6
	Systematic review: terlipressin in acute oesophageal variceal haemorrhage. GN Ioannou, J Doust, DC Rockey, Aliment Pharmacol Ther. 2003 Jan:53-64
	Transjugular intrahepatic portosystemic shunt versus endoscopic therapy: randomized trials for secondary prophylaxis of variceal bleeding: an updated meta-analysis. AK Burroughs, M Vangeli, Scand J Gastroenterol. 2002 Mar:249-52