| Endoscopic band ligation of esophageal varices in patients on anticoagulation. | |
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MedLine Citation:
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PMID: 18668702 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Endoscopic band ligation is an effective technique for primary and secondary prevention of gastro-esophageal variceal bleeding (GEVB), but can also result in rebleeding from postbanding ulcers. Its use in primary and secondary prevention of GEVB in anticoagulated patients has not been systematically studied. The aim of the study was to evaluate the feasibility of band ligation in primary and secondary prevention of GEVB in anticoagulated patients. Five patients (age 60.2+/-7.3 SD years: 3 males, 2 females) with esophageal varices on anticoagulation were studied using a retrospective chart review in a tertiary hospital setting. Patients were on mandatory anticoagulation with warfarin (international normalized ratio >2), on nonselective beta-blocker therapy if tolerated and were not transvenous intrahepatic porto-systemic shunting candidates. One patient had polycythemia vera (noncirrhotic), the rest were cirrhotics Child class B/C (1 cardiogenic, 1 primary sclerosing cholangitis, 1 Budd-Chiari, and 1 cryptogenic cirrhosis). Two patients had experienced prior acute GEVB; band ligation performed during acute bleeding was not included in the study. All patients had at least grade III-IV esophageal varices on outpatient follow-up for band ligation. Three bands were placed/patient and study patients underwent 3 banding sessions on an average. None of the patients developed GEVB after band ligation. In 3 patients banding resulted in complete variceal eradication, the remaining 2 are still being followed-up for outpatient band ligation. In conclusion, this case series suggests that endoscopic band ligation can potentially be used in anticoagulated patients without alternatives for prevention of acute GEVB. |
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Authors:
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Jasmohan S Bajaj; Jose Franco |
Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: Journal of clinical gastroenterology Volume: 42 ISSN: 1539-2031 ISO Abbreviation: J. Clin. Gastroenterol. Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-07-29 Completed Date: 2008-10-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7910017 Medline TA: J Clin Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: 782-5 Citation Subset: IM |
Affiliation:
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Division of Gastroenterology and Hepatology, Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anticoagulants / therapeutic use* Esophageal and Gastric Varices / surgery* Esophagoscopy / methods* Female Gastrointestinal Hemorrhage / drug therapy, prevention & control, surgery* Humans Ligation / methods* Male Middle Aged Treatment Outcome Warfarin / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 81-81-2/Warfarin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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