{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:00:58Z","timestamp":1790719258659,"version":"4.1.0"},"reference-count":43,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>\n            Background Prophylactic endoscopic variceal band ligation (EVL) is frequently performed in patients with liver cirrhosis. The aim of our study was to identify factors associated with early upper gastrointestinal bleeding (UGIB) in cirrhosis patients after prophylactic EVL.<\/jats:p><jats:p>\n            Methods 787 nonemergency EVLs performed in 444 patients in two German University medical centers were analyzed retrospectively. <\/jats:p><jats:p>\n            Results Within 30 days after EVL, 38 UGIBs were observed (4.8\u200a% of all procedures). Bilirubin levels (hazard ratio [HR] 1.5, 95\u200a% confidence interval [CI] 1.2\u20132.0 for a 2-fold increase) and presence of varices grade III\/IV according to Paquet (HR 2.6, 95\u200a%CI 1.3\u20135.0 compared with absence or smaller sized varices) were independently associated with UGIB following EVL. International normalized ratio (INR) was associated with bleeding events in the univariate analysis but did not reach statistical significance after adjustment for bilirubin and presence of varices grade III\/IV (HR 1.2, 95\u200a%CI 0.9\u20131.6 for an increase by 0.25). There was no statistically significant association between platelet count or fibrinogen levels and UGIB. Substitution of coagulation products did not affect incidence of bleeding after EVL, which also applied to patients with \u201ccoagulopathy\u201d (INR\u200a&gt;\u200a1.5 and\/or platelet count\u200a&lt;\u200a50\u200a\u00d7\u200a109\/L). No association between proton pump inhibitor therapy and post-EVL UGIB was observed.<\/jats:p><jats:p>\n            Conclusions EVL is a safe procedure and immediate bleeding complications are rare. Serum bilirubin levels and size of varices, rather than coagulation indices, are associated with UGIB after EVL. Our data do not support the preventive substitution of blood or coagulation products.<\/jats:p>","DOI":"10.1055\/a-1214-5355","type":"journal-article","created":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T22:41:17Z","timestamp":1599518477000},"page":"226-234","source":"Crossref","is-referenced-by-count":33,"title":["Risk factors associated with bleeding after prophylactic endoscopic variceal ligation in cirrhosis"],"prefix":"10.1055","volume":"53","author":[{"given":"Andreas","family":"Drolz","sequence":"first","affiliation":[{"name":"Department of Internal Medicine I, University Medical Center Hamburg Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Schramm","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospital Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Seiz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Medical Center Hamburg Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Groth","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Endoscopy, University Medical Center Hamburg Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eik","family":"Vettorazzi","sequence":"additional","affiliation":[{"name":"Department of Medical Biometry and Epidemiology, University Medical Center, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Horvatits","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Medical Center Hamburg Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malte H.","family":"Wehmeyer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Medical Center Hamburg Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Schramm","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Medical Center Hamburg Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Goeser","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospital Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Roesch","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Endoscopy, University Medical Center Hamburg Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ansgar W.","family":"Lohse","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Medical Center Hamburg Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Kluwe","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, University Medical Center Hamburg Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,9,7]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.cld.2013.12.005","article-title":"Primary prophylaxis of variceal bleeding","volume":"18","author":"D A Simonetto","year":"2014","journal-title":"Clin Liver Dis"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1002\/hep.30220","article-title":"Comparison of therapies for primary prevention of esophageal variceal bleeding: a systematic review and network meta-analysis","volume":"69","author":"M Sharma","year":"2019","journal-title":"Hepatology"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1111\/j.1365-2036.2008.03729.x","article-title":"Review article: the modern management of portal hypertension - primary and secondary prophylaxis of variceal bleeding in cirrhotic patients","volume":"28","author":"J C Garcia-Pagan","year":"2008","journal-title":"Aliment Pharmacol Ther"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/S0950-3528(97)90038-5","article-title":"Natural history. 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