Bleeding risk of variceal band ligation in extrahepatic portal vein obstruction is not increased by oral anticoagulation
| Autor: | Christophe Bureau, Charles-Dominique Valla, Jean-Pierre Vinel, Maeva Guillaume, Aurélie Plessier, Michèle Corbic, Pierre-Emmanuel Rautou, Jean-Marie Peron, Agnès Sommet, Yann Consigny, Camille Christol |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Administration Oral Context (language use) Esophageal and Gastric Varices Risk Assessment Severity of Illness Index Gastroenterology Drug Administration Schedule Perioperative Care Group B 03 medical and health sciences 0302 clinical medicine Internal medicine Severity of illness Humans Medicine Ligation Venous Thrombosis Hepatology Portal Vein business.industry Incidence (epidemiology) Anticoagulants Middle Aged medicine.disease Thrombosis 030220 oncology & carcinogenesis Portal hypertension Female 030211 gastroenterology & hepatology Upper gastrointestinal bleeding Gastrointestinal Hemorrhage business Follow-Up Studies |
| Zdroj: | European Journal of Gastroenterology & Hepatology. 30:563-568 |
| ISSN: | 0954-691X |
| DOI: | 10.1097/meg.0000000000001061 |
| Popis: | Background and objectives Noncirrhotic nontumoral extrahepatic portal vein obstruction (EHPVO) is the second leading cause of portal hypertension (PHT) and is mainly related to prothrombotic disorders. Patients with EHPVO often require prolonged oral anticoagulation therapy (OAT) together with variceal band ligation (VBL) to prevent thrombosis recurrence and PHT-related bleeding, respectively. The benefit-risk balance of VBL in this context remains unknown. We aimed to assess upper gastrointestinal bleeding (UGB) risk and variceal eradication efficacy in EHPVO patients undergoing a VBL program without stopping OAT. Patients and methods All patients with EHPVO treated (group A) or not (group B) with OAT and undergoing the VBL program were included between 2001 and 2010 in two tertiary French liver centers. We compared the incidence, source, and severity of UGB and variceal eradication efficacy. All EHPVO patients were then matched 1 : 1 with compensated cirrhotic patients with PHT not receiving OAT (group C) to compare UGB incidence and VBL efficacy. Results Forty-three EHPVO patients (30 with and 13 without OAT) and 43 cirrhotic patients were included for a total of 471 VBL sessions. The incidence of UGB was similar between group A (nine episodes/121 sessions) and group B (6/130), and tended to be higher in EHPVO patients (group A and B) than in cirrhotic patients (2/220). There was no difference between groups when considering bleeding source or severity and variceal eradication efficacy (84%). Conclusion VBL can be performed safely and efficiently without stopping anticoagulation therapy in EHPVO patients. |
| Databáze: | OpenAIRE |
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