Original articleClinical endoscopyEndoscopic variceal ligation as primary prophylaxis for upper GI bleeding in children
Section snippets
Study design
The aim of this study was to evaluate the efficacy and safety of primary prophylaxis with EVL to prevent UGIB compared with NSBB prophylaxis. Therefore, an ambispective single-center cohort study of pediatric patients with PH and EV was designed, and 2 study groups were assigned: EVL and propranolol groups.
The study was conducted in compliance with the provisions of the Declaration of Helsinki and Good Clinical Practice guidelines. This study was approved by the Hospital Vall d'Hebron
Results
From January 2014 to April 2018, 32 patients with EV and PH received EVL as a primary prophylaxis of UGIB (EVL group). They were compared with 32 consecutive patients who received propranolol from March 2009 to December 2013 (propranolol group). No differences were observed between groups in terms of gender, age, weight, etiology of PH, and follow-up. The overall endoscopic pattern was also comparable between both groups. No other differences were found in laboratory data or in radiologic
Discussion
Primary prophylaxis of variceal hemorrhage, while generally accepted for adults, has not been endorsed for children with PH.3,11 The risk of bleeding and the efficacy of primary prophylactic therapy for children with varices have been inadequately quantified, and therefore no overall recommendation for prophylactic treatment of children can be provided.11
Propranolol has been used anecdotally in children with PH. All previous studies using propranolol as primary prophylactic for UGIB were case
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DISCLOSURE: All authors disclosed no financial relationships.