{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:27:46Z","timestamp":1791851266364,"version":"4.3.4"},"reference-count":51,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2012,3,26]],"date-time":"2012-03-26T00:00:00Z","timestamp":1332720000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In patients with oesophageal varices, the combination of endoscopic variceal ligation (<jats:styled-content style=\"fixed-case\">EVL<\/jats:styled-content>) and medical therapy is recommended as standard of care for prevention of rebleeding. The results of previous meta\u2010analyses on this topic are equivocal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To assess the effects of <jats:styled-content style=\"fixed-case\">EVL<\/jats:styled-content> plus medical therapy vs. monotherapy (<jats:styled-content style=\"fixed-case\">EVL<\/jats:styled-content> or medical therapy alone) for secondary prevention in oesophageal varices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Electronic and manual searches were combined. The primary outcome measures were overall rebleeding (variceal and nonvariceal) and mortality. Random\u2010effects meta\u2010analyses were performed with subgroup, sensitivity, regression and sequential analyses to identify sources of intertrial heterogeneity and the robustness of the results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine randomised trials were included. In total, 442 patients were randomised to combination therapy and 513 to monotherapy. Combination therapy reduced rebleeding (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\u00a0=\u00a00.68; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00.54\u20130.85; number needed to treat eight patients). The result was confirmed in sequential and regression analyses, but not when limiting the analysis to trials with adequate selection bias control. No effect on overall mortality was identified (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\u00a0=\u00a00.89; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00.65\u20131.21). Combination therapy reduced bleeding\u2010related mortality (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\u00a0=\u00a00.52; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.27\u20130.99; number needed to treat 33 patients) and the risk of rebleeding from oesophageal varices. Combination therapy increased the risk of serious adverse events in fixed, but not in random\u2010effects meta\u2010analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The combination of <jats:styled-content style=\"fixed-case\">endoscopic variceal ligation<\/jats:styled-content> and medical therapy reduce the risk of rebleeding, but not overall mortality. Additional research is needed to determine why reduced rebleeding rates do not lead to reduced mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-2036.2012.05074.x","type":"journal-article","created":{"date-parts":[[2012,3,26]],"date-time":"2012-03-26T23:17:15Z","timestamp":1332803835000},"page":"1155-1165","source":"Crossref","is-referenced-by-count":89,"title":["Meta\u2010analysis: banding ligation and medical interventions for the prevention of rebleeding from oesophageal varices"],"prefix":"10.1111","volume":"35","author":[{"given":"M.","family":"Thiele","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Copenhagen University Hospital Gentofte Hellerup Denmark"},{"name":"Department of Gastroenterology and Hepatology Copenhagen University Hospital Koege Koege Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Krag","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Copenhagen University Hospital Gentofte Hellerup Denmark"},{"name":"Department of Gastroenterology and Hepatology Copenhagen University Hospital Hvidovre Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Rohde","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Copenhagen University Hospital Hvidovre Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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