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The effects of endoscopic variceal ligation and propranolol on portal hypertensive gastropathy: a prospective, controlled trial.
Lo, G H; Lai, K H; Cheng, J S; Hsu, P I; Chen, T A; Wang, E M; Lin, C K; Chiang, H T.
Afiliación
  • Lo GH; Division of Gastroenterology, Department of Medicine, Kaohsiung Veterans General Hospital, National Yang-Ming Medical College, Taipei, Taiwan.
Gastrointest Endosc ; 53(6): 579-84, 2001 May.
Article en En | MEDLINE | ID: mdl-11323582
BACKGROUND: Endoscopic treatment of esophageal varices may accentuate portal hypertensive gastropathy. The impact of the combination of band ligation and propranolol on this condition remains unknown. METHODS: Patients with history of variceal bleeding were randomized to receive band ligation alone (control group, 40 patients) or a combination of band ligation and propranolol (propranolol group, 37 patients). Serial endoscopic evaluation of gastropathy was performed. Gastropathy was classified into 3 grades and scored as 0, 1, or 2. RESULTS: Before endoscopic treatment, 17% of the control group and 22% of the propranolol group had gastropathy (p = 0.78). The occurrence of gastropathy after endoscopic treatment was significantly higher in the control group than in the propranolol group (p = 0.002). Serial endoscopic follow-up revealed that the mean gastropathy score was significantly higher in the control group than in the propranolol group (p < 0.05). In patients with gastropathy the gastropathy score reached a peak at 6 months after endoscopic treatment in both the control and propranolol groups (85% vs. 48%, respectively). After variceal obliteration, accentuation of gastropathy was significant in the control group (p < 0.01) but not in the propranolol group. Gastropathy was less likely to develop in patients who developed gastric varices. Esophageal variceal recurrence was not related to the development of gastropathy after variceal obliteration with banding. Only one patient in the control group bled from gastropathy. CONCLUSION: Band ligation of esophageal varices may accentuate gastropathy, which in this study was partly relieved by propranolol.
Asunto(s)
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Propranolol / Gastropatías / Vasodilatadores / Endoscopía Gastrointestinal / Hipertensión Portal / Ligadura Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Gastrointest Endosc Año: 2001 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Propranolol / Gastropatías / Vasodilatadores / Endoscopía Gastrointestinal / Hipertensión Portal / Ligadura Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Gastrointest Endosc Año: 2001 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Estados Unidos