{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:31:00Z","timestamp":1791851460902,"version":"4.3.4"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":5266,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2001,4]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Despite publication of several randomized trials of prophylactic variceal ligation, the effect on bleeding\u2013related outcomes is unclear. We performed a meta\u2013analysis of the trials, as identified by electronic database searching and cross\u2013referencing. Both investigators independently applied inclusion and exclusion criteria, and abstracted data from each trial. Standard meta\u2013analytic techniques were used to compute relative risks and the number needed to treat (NNT) for first variceal bleed, bleed\u2013related mortality, and all\u2013cause mortality. Among 601 patients in 5 homogeneous trials comparing prophylactic ligation with untreated controls, relative risks of first variceal bleed, bleed\u2013related mortality, and all\u2013cause mortality were 0.36 (0.26\u20130.50), 0.20 (0.11\u20130.39), and 0.55 (0.43\u20130.71), with respective NNTs of 4.1, 6.7, and 5.3. Among 283 subjects from 4 trials comparing ligation with \u03b2\u2013blocker therapy, the relative risk of first variceal bleed was 0.48 (0.24\u20130.96), with NNT of 13; however, there was no effect on either bleed\u2013related mortality (relative risk [RR], 0.61; confidence interval [CI], 0.20\u20131.88) or all\u2013cause mortality (RR, 0.95; CI, 0.56\u20131.62). In conclusion, compared with untreated controls, prophylactic ligation reduces the risks of variceal bleeding and mortality. Compared with \u03b2\u2013blockers, ligation reduces the risk for first variceal bleed but has no effect on mortality. Prophylactic ligation should be considered for patients with large esophageal varices who cannot tolerate \u03b2\u2013blockers. Subsequent research should further compare ligation and \u03b2\u2013blockers to determine the effect on mortality, and measure ligation's cost\u2013effectiveness.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1053\/jhep.2001.23054","type":"journal-article","created":{"date-parts":[[2002,8,25]],"date-time":"2002-08-25T03:46:10Z","timestamp":1030247170000},"page":"802-807","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":229,"title":["A Meta\u2013Analysis of Endoscopic Variceal Ligation for Primary Prophylaxis of Esophageal Variceal Bleeding"],"prefix":"10.1097","volume":"33","author":[{"given":"Thomas F.","family":"Imperiale","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naga","family":"Chalasani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1053%2Fjhep.2001.23054","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-200104000-00006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T11:26:51Z","timestamp":1733052411000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-200104000-00006"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,4]]},"references-count":0,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2001]]}},"URL":"https:\/\/doi.org\/10.1053\/jhep.2001.23054","relation":{},"ISSN":["0270-9139"],"issn-type":[{"value":"0270-9139","type":"print"}],"subject":[],"published":{"date-parts":[[2001,4]]}}}