Endoscopic Variceal Ligation Combined Smatostatin For Treatment Of Esophageal Variceal Hemorrhage:a Meta-Analysis

Objective:To evaluate the efficacy of endoscopic variceal ligation (EVL) with somatostatin on the rate of first esophageal variceal bleeding and the prevention of rehaemorrhagia in patients with cirrhosis.Methods:PubMed, EMBASE, WanFang Date, CNKI, Chongqing VIP Information Co., etc were searched for studies about EVL plus somatostatin on the rate of first esophageal variceal bleeding and the prevention of rehaemorrhagia in patients with cirrhosis. We screened studies identified for inclusion and determined study eligibility according to the criteria of inclusion and exclusion. Using Revman 5.0 to performe the Statistical analysis.Results:10 articles were entered this meta-analysis. There were 7 trials focus on the efficacy of EVL with somatostatin on the rate of first esophageal variceal bleeding.Summary OR of meta analys is 3.59,95% CI is (1.97,6.55),P< 0.0001,it means that the efficacy of EVL with somatostatin on the rate of first esophageal variceal bleeding had obvious advantages compared with only use EVL.9 trials focused on the prevention of rehaemorrhagia in endoscopic variceal patients with cirrhosis. Because of the heterogenicity,we took subgroup analysis and divided into groups by how to use the somatostatin. In the subgroup which use the somatostatin for 2-5days after the EVL, the Summary OR is 3.40,95%CI is (1.84,6.26),P<0.0001;in the subgroup which didn’t describe clearly how to use the Somatostatin after the EVL, the Summary OR is 0.27,95%CI is (0.13,0.53),P=0.0002.Conclusion:The treatment of EVL plus somatostatin for liver cirrhosis with esophageal variceal bleeding is more effective than only use EVL. Besides, keep on using the somatostatin for 2-5days after the EVL could prevent the rehaemorrhagia effectively.