Variceal band ligation can reduce the rate of the first variceal by 45% to 52% compared with beta-blockers.
Dr Dhiraj Tripathi and colleagues updated a meta-analysis of 9 randomized controlled trials published as full papers.
The trials compared variceal band ligation with beta-blocker for primary prevention including 734 patients.
Of these patients, 356 received variceal band ligation and 378 beta-blocker.
|The pooled relative risk favored variceal band ligation for first variceal bleed|
|Europaean Journal of Gastroenterology & Hepatology|
The team computed relative risk using a random effects model.
Sensitivity analysis was performed using a fixed effects model.
Publication bias was also assessed using funnel plots and the rank correlation test.
The researchers found that the pooled relative risk favored variceal band ligation for first variceal bleed, with number needed to treat being 13.
Variceal band ligation had a favored pooled relative risk in terms of adverse events resulting in treatment withdrawal, with the number needed to treat being 10.
The team found banding-related bleeding occurred in 6 patients.
The researchers observed no difference in bleeding-related deaths, or overall mortality.
The team noticed no significant heterogeneity or publication bias was present, and outcomes remained robust after sensitivity analyses.
Dr Tripathi's team concluded, "Variceal band ligation was superior to beta-blocker in preventing the first variceal bleed, with fewer adverse events resulting in treatment discontinuation."
"Careful attention to technique and patient selection are important to minimize iatrogenic complications with Variceal band ligation."
"Variceal band ligation has a role in patients with poor drug compliance, or tolerance, and in those who bleed on beta-blocker therapy."