{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T14:31:25Z","timestamp":1786545085419,"version":"build-2736575974"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2002,3]]},"abstract":"<jats:title>\n                    <jats:bold>ABSTRACT<\/jats:bold>\n                  <\/jats:title>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES:<\/jats:title>\n                    <jats:p>Variceal ligation has been shown to be superior to sclerotherapy in prevention of rebleeding and improving survival in patients with cirrhosis. However, 25% of patients will rebleed before completion of treatment. A number of trials have compared the combination of ligation and sclerotherapy to ligation alone in achieving rapid and complete eradication of esophageal varices, with conflicting results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Two reviewers independently identified seven randomized, controlled trials that compared endoscopic variceal ligation with the combination of sclerotherapy and ligation for the treatment of esophageal varices. Studies were identified by searching MEDLINE, reviewing references from retrieved articles, and scanning abstracts from conference proceedings. For each outcome, odds ratios (ORs) were calculated using fixed-effects and random-effects models. The Mantel-Haenszel test for statistical heterogeneity was used to assess the validity of combining results from individual studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      No significant difference was seen in cessation of actively bleeding varices (OR = 1.01, 95% CI = 0.43\u20132.36), variceal rebleeding (OR = 1.12, CI = 0.69\u20131.81), and mortality (OR = 1.1, CI = 0.70\u20131.74) in patients with variceal ligation\n                      <jats:italic toggle=\"yes\">versus<\/jats:italic>\n                      patients receiving the combination treatment of ligation and sclerotherapy. Treatment sessions required to achieve complete variceal eradication were similar in the two treatment arms. A significantly higher incidence of esophageal stricture was seen in combination therapy (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>The combination of ligation and sclerotherapy offers no advantage over ligation alone in prevention of rebleeding and in reduction of mortality. It is also associated with a higher complication rate of esophageal stricture.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/j.1572-0241.2002.05540.x","type":"journal-article","created":{"date-parts":[[2004,3,29]],"date-time":"2004-03-29T04:05:14Z","timestamp":1080533114000},"page":"623-629","source":"Crossref","is-referenced-by-count":78,"title":["Combined Ligation and Sclerotherapy Versus Ligation Alone for Secondary Prophylaxis of Esophageal Variceal Bleeding: A Meta-Analysis"],"prefix":"10.14309","volume":"97","author":[{"given":"Pankaj","family":"Singh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nakechand","family":"Pooran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anant","family":"Indaram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simmy","family":"Bank","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"b1_682","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/0016-5085(81)90144-X","volume":"80","author":"Graham DY","year":"1981","journal-title":"Gastroenterology"},{"key":"b2_683","doi-asserted-by":"crossref","first-page":"280","DOI":"10.7326\/0003-4819-123-4-199508150-00007","volume":"123","author":"Laine L.","year":"1995","journal-title":"Ann Intern Med"},{"key":"b3_684","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1056\/NEJM199206043262304","volume":"326","author":"Stiegmann GU","year":"1992","journal-title":"N Engl J Med"},{"key":"b4_685","first-page":"243","volume":"37","author":"Reveille RM","year":"1991","journal-title":"Gastrointest Endosc"},{"key":"b5_686","first-page":"A835","volume":"102","author":"Koutsomanias D.","year":"1992","journal-title":"Gastroenterology"},{"key":"b6_687","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1053\/gast.1996.v110.pm8566601","volume":"110","author":"Laine L.","year":"1996","journal-title":"Gastroenterology"},{"key":"b7_688","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.1997.v25.pm0008985267"},{"key":"b8_689","first-page":"950","volume":"92","author":"Bhargava DK","year":"1997","journal-title":"Am J Gastroenterol"},{"key":"b9_690","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1002\/hep.510280215","volume":"28","author":"Lo G.","year":"1998","journal-title":"Hepatology"},{"key":"b10_691","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0016-5107(99)70335-4","volume":"50","author":"Traif IA","year":"1999","journal-title":"Gastrointest Endosc"},{"key":"b11_692","doi-asserted-by":"publisher","DOI":"10.1055\/s-1999-22"},{"key":"b12_693","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/S0016-5107(00)70411-1","volume":"51","author":"Argonz J.","year":"2000","journal-title":"Gastrointest Endosc"},{"key":"b13_694","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"b14_695","doi-asserted-by":"crossref","first-page":"531","DOI":"10.7326\/0003-4819-127-7-199710010-00005","volume":"127","author":"Meade MO","year":"1997","journal-title":"Ann Intern Med"},{"key":"b15_696","first-page":"408","volume":"273","author":"Schultz KF","year":"1995","journal-title":"Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. 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