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Endoscopic management and outcome of non-variceal bleeding in patients with liver cirrhosis:A systematic review

World Journal of Gastrointestinal Endoscopy 2022年第3期14卷 163-175页

作者： georgios demetiou Aikaterini Augoustaki Evangelos Kalaitzakis Department of Gastroenterology University Hospital of HeraklionHeraklion 71500Greece

BACKGROUND Acute non-variceal bleeding accounts for approximately 20%of all-cause bleeding episodes in patients with liver *** is associated with high morbidity and mortality therefore prompt diagnosis and endoscopic management are *** To evaluate available data on the efficacy of endoscopic treatment modalities used to control acute non-variceal gastrointestinal bleeding(GIB)in cirrhotic patients as well as to assess treatment *** Employing PRISMA methodology,the MEDLINE was searched through PubMed using appropriate MeSH *** are reported in a summative manner and separately for each major non-variceal cause of *** Overall,23 studies were identified with a total of 1288 cirrhotic patients of whom 958/1288 underwent endoscopic therapy for acute non-variceal *** ulcer bleeding was the most common cause of acute non-variceal bleeding,followed by portal hypertensive gastropathy,gastric antral vascular ectasia,Mallory-Weiss syndrome,Dieaulafoy lesions,portal hypertensive colopathy,and *** to control bleeding from all-causes of non-variceal GIB accounted for less than 3.5%of cirrhotic ***(range 2%-25%)and mortality(range 3%-40%)rates varied,presumably due to study *** was usually managed endoscopically and salvage therapy using arterial embolisation or surgery was undertaken in very few *** was usually associated with liver function deterioration and other organ failure or infections rather than uncontrolled *** treatment-related complications were extremely *** acute non-variceal bleeding was examined in two studies(197/1288 patients)achieving initial hemostasis in all patients using argon plasma coagulation for portal hypertensive colopathy and endoscopic band ligation or sclerotherapy for bleeding hemorrhoids(rebleeding range 10%-13%).Data on the efficacy of endoscopic therapy of cirrhotic patients vs non-cirrhotic controls wi

关键词： Liver cirrhosis Non-variceal gastrointestinal hemorrhage Gastrointestinal endoscopy Endoscopic therapy Patient outcomes Peptic ulcer Mallory Weiss syndrome Gastric antral vascular ectasia

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