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

Table 1 Main characteristics of all included studies

Ref.	Type of study	Period of enrolment, years	Number of patients1	Number of cirrhotic patients with acute NVGIB	Non-variceal bleeding source	Endoscopic treatment modality	Main outcomes
Paquet et al[30]	Retrospective	1985-1987	339	53	MWS	EIS (polidocanol)	CoB
Baettig et al[35]	Retrospective	1984-1991	480 (28 with Dieulafoy’s lesion)	3	DL	EI + EIS (polidocanol)	CoB; Rebleeding; Mortality
Labenz et al[25]	Retrospective, case series	NR	5	3	GAVE	Nd-YAG LC	CoB; Post treatment TU (median f/up 8 mo)
Schuman et al[31]	Retrospective	1985-1990	42	14	MWS	BICAP electrocoagulation, Epinephrine injection	CoB; Severity of bleeding in relation to liver disease and/or PH2
Ikeda et al[16]	Retrospective	1993-1996	5	4	GAVE	EC or HPC	CoB; Eradication of GAVE; Endoscopic pattern and development of GAVE
Dulai et al[26]	Prospective	1991-1999	744 (26 with GAVE)	7	GAVE	Bipolar EC, HPC, APC	Hct pre- and post-treatment; TU needed; Number of hospitalizations pre- and post-treatment (median f/up 6 mo)
Cheng et al[36]	Retrospective	1999-2001	1393 (29 with DL)	5	DL	EI, EIS, HPC	CoB; Rebleeding; Mortality
Sato et al[17]	Retrospective	2001-2003	8	5	GAVE	APC	Recurrence of GAVE (mean f/up 28 mo); CoT (mean f/up 28 mo)
Higuchi et al[32]	Prospective	1998-2005	37	11	MWS	EBL	CoB; Rebleeding (28 d)
Lecleire et al[27]	Retrospective	2001-2005	30	11	GAVE	APC	CoB; GAVE pattern; Recurrence of symptoms (median f/up 20 mo); CoT (median f/up 20 mo)
Seo et al[18]	Retrospective multicenter	May-October 2005	464	76	GU, DU, OS	EC	CoB; Rebleeding (42 d); Mortality (42 d)
Lecleire et al[33]	Prospective	2001-2008	218	7	MWS	EBL or EI + HC	CoB; Rebleeding; TU needed; Mortality
Fuccio et al[28]	Prospective	2002-2006	20	4	GAVE	APC	Resolution of transfusion dependent anemia (mean f/up 25 mo); CoT (mean f/up 25 mo)
González-González et al[22]	Prospective	2000-2009	160	160	GU, DU, OS	BICAP EC, EI	CoB; Rebleeding; Mortality (in-hospital)
Gad et al[37]	Retrospective	2007-2011	77	77	PHC, OS	APC	CoB; PHC prevalence; PHC endoscopic pattern
Awad et al[38]	Prospective	2009-2010	120	120	Hemorrhoids	EBL, EIS (ethanolamine or N-butyl cyanoacrylate)	CoB; HR; Rebleeding; Pain relief; Patient’s satisfaction
Rudler et al[23]	Prospective	2008-2011	203	29	PU	EI, HC	CoB; Rebleeding; Mortality (30 d); RT
Sato et al[29]	Retrospective	NR	34	13	GAVE	APC, EBL	CoB; Rebleeding; Mortality; GAVE recurrence
Smith et al[34]	Retrospective, case series	NR	4	4	PHG, PHC	Hemospray	CoB; CoT
Morsy et al[24]	Prospective	2011-2012	532	93	GU, DU, OS	EI, APC	Early rebleeding (24 h after stabilising patient); Mortality (in-hospital)
Yang et al[19]	Retrospective	2007-2013	210	210	PU	EI, APC, HC	CoB; Rebleeding; Mortality (in-hospital); Infection (in-hospital); Length of hospital stay
Kuo et al[20]	Retrospective	2008-2014	235	235	PU	EI, APC, HC	CoB; Rebleeding; Mortality (in-hospital); Infection (in-hospital); Length of hospital stay
Ardevol et al[21]	Retrospective multicenter	2005-2012	790	144	PU	EI, Multipolar EC, HC, EIS	CoB; Rebleeding (1-45 d); Mortality (45 d, 1 year); RT

¹Including cirrhotics and non-cirrhotics with acute non-variceal gastrointestinal bleeding and cirrhotics with obscure gastrointestinal bleeding;

NR: Not reported; MWS: Mallory-Weiss syndrome; DL: Dieaulafoy’s lesion; GAVE: Gastric antral vascular ectasia; PHC: Portal hypertensive colopathy; PHG: Portal hypertensive gastropathy; LC: Lasercoagulation; APC: Argon plasma coagulation; EBL: Endoscopic band ligation; EIS: Endoscopic injection sclerotherapy; EI: Epineprhine injection, HPC: Heater probe coagulation; CoB: Control of bleeding; TU: Transfusion units; PH: Portal hypertension; Hct: Hematocrit; CoT: Complications of treatment; PU: Peptic ulcer; GU: Gastric ulcer; DU: Duodenal ulcer; OS: Other sources; HR: Hemorrhoids recurrence; RT: Rescue therapies.