Annals of Hepatology (Dec 2024)

P-125 FACTORS ASSOCIATED WITH THE DEVELOPMENT OF POST-BANDING ULCER BLEEDING IN PATIENTS WITH CIRRHOSIS.

  • Sandra Teutli Carrión,
  • Maria De Fatima Higuera De La Tijera,
  • Juan Carlos Silis Cravioto,
  • Julio Cesar Zavala Castillo

Journal volume & issue
Vol. 29
p. 101739

Abstract

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Conflict of interest: No Introduction and Objectives: Variceal bleeding accounts for 10-30% of cases of upper gastrointestinal bleeding and is the most common complication of portal hypertension. The treatment of choice is endoscopic band ligation. Post-banding ulcer bleeding (PBUB), although infrequent, is a complication. Objectives: To determine the predictive factors of bleeding due to PBUB in cirrhotic patients. Patients / Materials and Methods: This is a case-control study involving cirrhotic patients with esophageal varices who developed PBUB (cases) and those who did not develop PBUB (controls). Results and Discussion: From January 2012 to January 2024, 203 patients diagnosed with esophageal varices due to cirrhosis were included; 105 were men (51.7%) with a mean age of 57.8±10.9 years. The causes of cirrhosis were: 87 (42.9%) alcohol, 20 (9.9%) viral, 96 (47.3%) MASLD. According to the Child-Pugh classification: 53 (26.1%) were class A, 77 (37.9%) were class B, and 73 (36.0%) were class C. The indications for endoscopy were: 43 (21.2%) primary prophylaxis, 84 (41.4%) secondary prophylaxis, and 76 (37.4%) active bleeding. A total of 160 patients (78.8%) were taking non-selective beta-blockers (BBNS). We found 61 cases (30.0%) of PBUB.In the univariate analysis, the following were associated with a higher risk of developing PBUB: post-ligation fibrosis [32/136 (23.5%) vs. 29/67 (43.3%); OR=1.8; 95% CI: 1.2-2.8; p=0.004], the presence of endoscopic signs of poor prognosis [13/122 (10.7%) vs. 48/81 (59.2%); OR=5.6; 95% CI: 3.2-9.6; p<0.0001], and the decompensated state of cirrhosis [Child A: 2/53 (3.8%) vs. Child B: 17/77 (22.1%) OR=7.2; 95% CI: 1.6-32.8 vs. Child C: 42/73 (57.5%) OR=34.5; 95% CI: 7.8-152.8; p<0.0001]. The multivariate analysis is shown in Table 1. Conclusions: Greater cirrhosis decompensation is associated with a higher risk of PBUB; the presence of red signs of poor prognosis at the time of endoscopy also has an influence.