{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T21:17:02Z","timestamp":1784927822816,"version":"3.55.0"},"reference-count":24,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,12,13]],"date-time":"2022-12-13T00:00:00Z","timestamp":1670889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Chang Gung Medical Research Program","award":["CORPG3J0531"],"award-info":[{"award-number":["CORPG3J0531"]}]},{"name":"Chang Gung Medical Research Program","award":["CORPG3L0261"],"award-info":[{"award-number":["CORPG3L0261"]}]},{"name":"Chang Gung Medical Research Program","award":["CORPG3J0501"],"award-info":[{"award-number":["CORPG3J0501"]}]},{"name":"Chang Gung Medical Research Program","award":["CMRPG3K0771"],"award-info":[{"award-number":["CMRPG3K0771"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Endoscopic variceal ligation (EVL) is the primary and secondary treatment for acute esophageal variceal bleeding. Post-banding ulcer bleeding (PBUB) may lead to bleeding episodes following EVL, increasing mortality. The aim of this study was to evaluate the risk factors for PBUB and predict the 6-week mortality risk after PBUB. Materials and Methods: We retrospectively analyzed the data collected from cirrhotic patients with EVL from 2015 to 2017. The incidence of PBUB and the 6-week mortality rate were evaluated. Risk factors for PBUB and predictive factors for mortality after PBUB were analyzed. Results: A total of 713 patients were enrolled in this study. Among the studied subjects, the incidence of PBUB was 5.8% (N = 41). The 6-week mortality rate was 63.4% (26\/41). In multivariate analysis, MELD score \u226520 (OR: 3.77, 95% CI: 1.94\u20137.33, p &lt; 0.001), ALBI score of 3 (OR: 2.67, 95% CI: 1.34\u20135.3, p = 0.005) and the presence of gastric varices (OR: 2.1, 95% CI: 1.06\u20134.16, p = 0.03) were associated with the development of PBUB. Patients with ALBI grade 3 (OR: 4.8, 95% CI: 1.18\u201319.6, p = 0.029) and Child-Pugh scores B and C (OR: 16.67, 95% CI: 1.75\u2013158.1, p = 0.014) were associated with 6-week mortality after PBUB. Conclusions: PBUB is a complication with low incidence but increased mortality following EVL. The ALBI grade is a useful score to predict not only the development of PBUB but also the 6-week mortality after PBUB.<\/jats:p>","DOI":"10.3390\/medicina58121836","type":"journal-article","created":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T02:22:41Z","timestamp":1670984561000},"page":"1836","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Albumin-Bilirubin Grade as a Novel Predictor of the Development and Short-Term Survival of Post-Banding Ulcer Bleeding Following Endoscopic Variceal Ligation in Cirrhotic Patients"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9438-0398","authenticated-orcid":false,"given":"Chun-Wei","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Jung","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6853-4557","authenticated-orcid":false,"given":"Chao-Wei","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tony","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Tang","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Jung","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siew-Na","family":"Lim","sequence":"additional","affiliation":[{"name":"College of Medicine, Chang Gung University, Taoyuan 333, Taiwan"},{"name":"Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chau-Ting","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan 333, Taiwan"},{"name":"Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wey-Ran","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan"},{"name":"College of Medicine, Chang Gung University, Taoyuan 333, Taiwan"},{"name":"Liver Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,13]]},"reference":[{"key":"ref_1","first-page":"310","article-title":"Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases","volume":"65","author":"Abraldes","year":"2016","journal-title":"Hepatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1056\/NEJMra0901512","article-title":"Management of Varices and Variceal Hemorrhage in Cirrhosis","volume":"362","author":"Bosch","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1111\/j.1572-0241.2001.03460.x","article-title":"Incidence and Management of Esophageal Stricture Formation, Ulcer Bleeding, Perforation, and Massive Hematoma Formation From Sclerotherapy Versus Band Ligation","volume":"96","author":"Schmitz","year":"2001","journal-title":"Am. J. Gastroenterol."},{"key":"ref_4","first-page":"105","article-title":"Results of experimental endoscopic esophageal varix ligation","volume":"54","author":"Stiegmann","year":"1988","journal-title":"Am. Surg."},{"key":"ref_5","first-page":"2281","article-title":"Natural history of postligation ulcers","volume":"89","author":"Nijhawan","year":"1994","journal-title":"Am. J. Gastroenterol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.dld.2019.06.019","article-title":"Ulcer bleeding after band ligation of esophageal varices: Risk factors and prognosis","volume":"52","author":"Cachero","year":"2020","journal-title":"Dig. Liver Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.gie.2012.08.031","article-title":"Interventions and outcomes of treatment of postbanding ulcer hemorrhage after endoscopic band ligation: A single-center case series","volume":"77","author":"Tierney","year":"2013","journal-title":"Gastrointest. Endosc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1055\/a-1214-5355","article-title":"Risk factors associated with bleeding after prophylactic endoscopic variceal ligation in cirrhosis","volume":"53","author":"Drolz","year":"2020","journal-title":"Endoscopy"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e7157","DOI":"10.1097\/MD.0000000000007157","article-title":"Endoscopic variceal ligation-induced ulcer bleeding: What are the risk factors and treatment strategies?","volume":"96","author":"Cho","year":"2017","journal-title":"Medicine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1097\/MEG.0000000000000387","article-title":"Risk factors for band-induced ulcer bleeding after prophylactic and therapeutic endoscopic variceal band ligation","volume":"27","author":"Sinclair","year":"2015","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1016\/j.cgh.2009.04.019","article-title":"A Prospective Study of Conventional and Expanded Coagulation Indices in Predicting Ulcer Bleeding After Variceal Band Ligation","volume":"7","author":"Caldwell","year":"2009","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/j.1365-2036.2010.04331.x","article-title":"Predictive factors of bleeding related to post-banding ulcer following endoscopic variceal ligation in cirrhotic patients: A case-control study","volume":"32","author":"Vanbiervliet","year":"2010","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1053\/jhep.2003.50346","article-title":"A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C","volume":"38","author":"Wai","year":"2003","journal-title":"Hepatology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1002\/hep.21178","article-title":"Development of a simple noninvasive index to predict significant fibrosis in patients with HIV\/HCV coinfection","volume":"43","author":"Sterling","year":"2006","journal-title":"Hepatology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1200\/JCO.2014.57.9151","article-title":"Assessment of Liver Function in Patients With Hepatocellular Carcinoma: A New Evidence-Based Approach\u2014The ALBI Grade","volume":"33","author":"Johnson","year":"2015","journal-title":"J. Clin. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1053\/j.gastro.2013.10.018","article-title":"A MELD-Based Model to Determine Risk of Mortality Among Patients With Acute Variceal Bleeding","volume":"146","author":"Reverter","year":"2014","journal-title":"Gastroenterology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.cgh.2017.04.042","article-title":"Multicenter External Validation of Risk Stratification Criteria for Patients With Variceal Bleeding","volume":"16","author":"Conejo","year":"2018","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1159\/000479984","article-title":"Validation and Potential of Albumin-Bilirubin Grade and Prognostication in a Nationwide Survey of 46,681 Hepatocellular Carcinoma Patients in Japan: The Need for a More Detailed Evaluation of Hepatic Function","volume":"6","author":"Hiraoka","year":"2017","journal-title":"Liver Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e7142","DOI":"10.1097\/MD.0000000000007142","article-title":"Albumin-bilirubin (ALBI) score at admission predicts possible outcomes in patients with acute-on-chronic liver failure","volume":"96","author":"Chen","year":"2017","journal-title":"Medicine"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1111\/liv.13527","article-title":"Validation of the albumin-bilirubin grade-based integrated model as a predictor for sorafenib-failed hepatocellular carcinoma","volume":"38","author":"Lee","year":"2017","journal-title":"Liver Int."},{"key":"ref_21","first-page":"178","article-title":"Clinical application of Albumin-Bilirubin (ALBI) score: The current status","volume":"18","author":"Deng","year":"2020","journal-title":"Surg. J. R. Coll. Surg. Edinb. Irel."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Sakamaki, A., Takamura, M., Sakai, N., Watanabe, Y., Arao, Y., Kimura, N., Setsu, T., Abe, H., Yokoo, T., and Kamimura, H. (2022). Longitudinal increase in albumin\u2013bilirubin score is associated with non-malignancy-related mortality and quality of life in patients with liver cirrhosis. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0263464"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1053\/jlts.2002.35927","article-title":"The new liver allocation system: Moving toward evidence-based transplantation policy","volume":"8","author":"Freeman","year":"2002","journal-title":"Liver Transplant."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.jhep.2015.05.022","article-title":"Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension","volume":"63","author":"Baveno","year":"2015","journal-title":"J. Hepatol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/12\/1836\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:40:41Z","timestamp":1760146841000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/12\/1836"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,13]]},"references-count":24,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["medicina58121836"],"URL":"https:\/\/doi.org\/10.3390\/medicina58121836","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,13]]}}}