{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T20:54:43Z","timestamp":1785790483410,"version":"3.56.0"},"reference-count":22,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Gastric variceal bleeding is a common and serious complication of liver cirrhosis and carries a high mortality. Endoscopic variceal ligation (EVL) is widely used, but its efficacy for gastric varices is limited by incomplete variceal capture and a high rate of post-ligation rebleeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate the effectiveness and safety of metal clip-assisted endoscopic variceal ligation (MEVL) versus traditional ligation (TL) in adults with cirrhotic gastric varices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Single-center retrospective observational cohort study, reported according to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Adults with cirrhosis and gastroesophageal (gastroesophageal varices)-type varices undergoing elective ligation for primary or secondary prophylaxis at Henan Provincial People\u2019s Hospital between May 2019 and December 2023 were included; emergency endoscopies were excluded. Non-selective beta-blocker co-therapy was standardized. Baseline imbalance was addressed by propensity score matching and inverse probability of treatment weighting (IPTW), pre-specified as the primary balancing method. Multivariable logistic regression, Cox proportional hazards modeling, and post hoc power were computed in SPSS 26 and Python 3.11.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Ninety-nine patients were analyzed (MEVL\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200946; TL\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200953) with comparable baseline characteristics. One-session eradication was achieved in 33 of 46 MEVL patients (71.7%) compared with 26 of 53 TL patients (49.1%), favoring MEVL after IPTW adjustment (odds ratio (OR) 2.55, 95% confidence interval (CI) 1.03\u20136.27;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.042) and on Cox regression (adjusted hazard ratio 1.53, 95% CI 1.00\u20132.35;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.049). Early rebleeding between 120\u2009h and 6\u2009weeks occurred in 0 of 46 MEVL patients versus 5 of 53 TL patients (9.4%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.059; post hoc power 87%); the adjusted OR for any rebleeding favored MEVL (0.24, 95% CI 0.07\u20130.82;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.023). All-cause mortality (3\/46 vs 6\/53) and adverse reactions (11\/46 vs 14\/53) did not differ.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>MEVL was associated with higher one-session eradication than TL, with no increase in adverse reactions. A reduction in cumulative rebleeding was suggested by adjusted logistic regression but was not confirmed by time-to-event Cox analysis; this finding should be interpreted as exploratory rather than definitive. Multicenter prospective validation is required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration:<\/jats:title>\n                    <jats:p>Since this is a retrospective, non-randomized study, it was not registered as a clinical trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17562848261453281","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T09:43:02Z","timestamp":1781689382000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Preliminary research on the effectiveness and safety of metal clip-assisted endoscopic variceal ligation in the treatment of gastric varices"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7159-1809","authenticated-orcid":false,"given":"Wang","family":"Yi","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Henan Provincial People\u2019s Hospital, People\u2019s Hospital of Zhengzhou University, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3313-4801","authenticated-orcid":false,"given":"Li","family":"Xiuling","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Henan Provincial People\u2019s Hospital, People\u2019s Hospital of Zhengzhou University, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9165-3876","authenticated-orcid":false,"given":"Ding","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Henan Provincial People\u2019s Hospital, People\u2019s Hospital of Zhengzhou University, Zhengzhou 450003, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3054-9645","authenticated-orcid":false,"given":"Li","family":"Zhenjuan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Henan Provincial People\u2019s Hospital, People\u2019s Hospital of Zhengzhou University, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2502-115X","authenticated-orcid":false,"given":"Li","family":"Jiaxin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Henan Provincial People\u2019s Hospital, People\u2019s Hospital of Zhengzhou University, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9179-2385","authenticated-orcid":false,"given":"Quan","family":"Runzhao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Henan Provincial People\u2019s Hospital, People\u2019s Hospital of Zhengzhou University, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"issue":"2","key":"e_1_3_4_2_2","first-page":"143","article-title":"Prevalence and outcome of peptic ulcer bleeding in patients with liver cirrhosis","volume":"50","author":"Gado A","year":"2014","unstructured":"Gado A, Ebeid B, Axon A. 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