[A prognostic analysis of cirrhotic esophageal variceal bleeding treated with standardized endoscopic therapy]

Objective: To analyze the clinical effect of standardized endoscopic esophageal variceal ligation alone or in combination with tissue adhesive injection for gastric varices (GV) after the first cirrhotic esophageal variceal bleeding. Methods: A total of 97 patients who underwent a successful endoscopic therapy in our hospital due to the first cirrhotic esophageal variceal bleeding were enrolled, and according to the subsequent therapeutic regimen, they were divided into control group (48 patients) and treatment group (49 patients). The patients in the control group were given conservative treatment alone, and those in the treatment group were given endoscopic therapy regularly. The therapeutic regimen, changes in varices, complications, and death caused by rebleeding were compared between the two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test or Fisher's exact test was used for comparison of categorical data between groups. Results: The treatment group achieved a remission rate of esophageal varices (EV) of 100% and a GV elimination rate of 93.75% after 2-3 times of endoscopic therapy; the EV recurrence, rebleeding, and mortality rates were 2.04%, 0, and 0, respectively, within 1 month, 16.33%, 4.08%, and 0, respectively, within 12 months, and 20.40%, 14.29%, and 4.08%, respectively, within 20 months; the incidence rate of gastric variceal bleeding (GVB) was 0. In the control group, the EV recurrence, rebleeding, and mortality rates were 4.17%, 2.08%, and 2.08%, respectively, within 1 month, 41.67%, 33.33%, and 8.33%, respectively, within 12 months, and 72.92%, 56.25%, and 20.83%, respectively, within 20 months; the incidence rate of GVB was 18.75%. There were significant differences between the two groups in the incidence rate of GVB (χ (2) = 13.605, P = 0.001) and EV long-term recurrence, rebleeding, and mortality rates (12 months: χ (2) = 16.326, P < 0.01; 20 months: χ (2) = 27.144, P < 0.01). Conclusion: Gastroscopy and continuous endoscopic therapy for 2-3 times should be performed regularly after the first cirrhotic esophageal variceal bleeding to alleviate EV, eliminate GV, and reduce rebleeding and mortality rates.