Tu1081 PREDICTIVE FACTORS OF POST-BANDING ULCER BLEEDING FOLLOWING ENDOSCOPIC VARICES LIGATION IN PATIENTS WITH LIVER CIRRHOSIS

Abstract

Esophageal varices bleeding is a major complication of liver cirrhosis. Endoscopic varices ligation (EVL) has been recommend for prevention of esophageal varices bleeding as well as emergent treatment for acute esophageal varices bleeding. However, post-banding ulcer may lead to another lethal bleeding episode. The aim of this study is to evaluate the risk factors of post-banding ulcer bleeding (PBUB) following endoscopic varices ligation. From Jan 2015 to Oct 2017, patients underwent EVL were retrospectively evaluated in a tertiary medical center of northern Taiwan. The PBUB was defined as upper gastrointestinal bleeding episode with upper endoscopy evaluation within 2 weeks after EVL. The demographic, clinical and endoscopic data were collected at the time of EVL. Categorical variables were compared by using Chi-square test and continuous variables were compared by using the Student t test. Univariate and multivariate logistic regression was performed to determine the predictive factors of PBUB. A total of 714 patients were included in this study. 41 (5.7%) patients suffered from PBUB. The baseline clinical and endoscopic characteristics of the studied patients were shown in Table 1. The mean age in post-banding ulcer bleeding group was significantly younger than that in non-PBUB group (53.95±11.53 Vs 58.35±12.48, p=0.028). In laboratory data, the prothrombin time, total bilirubin, ALT were significantly higher in PBUB group than those in non-PBUB group and albumin was significantly lower in PBUB group than that in non-PBUB group. The logistic regression for risk factors of PBUB was shown in Table 2. In univariate analysis, the prothrombin time (INR) >2.3, total bilirubin >3.0 mg/dl and sodium >150 mEq/l were associated with PBUB. In multivariate analysis, total bilirubin > 3.0 mg/dl and concomitant gastric varices were associated with development of PBUB. Cirrhotic patients with concomitant gastric varices and total bilirubin > 3.0 mg/dl have higher risks for development of PBUB.View Large Image Figure ViewerDownload Hi-res image Download (PPT)