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| 1 | Defining the advantages and exposing the limitations of endoscopic variceal ligation in controlling acute bleeding and achieving complete variceal eradication显示文摘BACKGROUND Bleeding esophageal varices(BEV)is a potentially life-threatening complication in patients with portal hypertension with mortality rates as high as 25%within six weeks of the index variceal bleed.After control of the initial bleeding episode patients should enter a long-term surveillance program with endoscopic intervention combined with non-selectiveβ-blockers to prevent further bleeding and eradicate EV.AIM To assess the efficacy of endoscopic variceal ligation(EVL)in controlling acute variceal bleeding,preventing variceal recurrence and rebleeding and achieving complete eradication of esophageal varices(EV)in patients who present with BEV.METHODS A prospectively documented single-center database was used to retrospectively identify all patients with BEV who were treated with EVL between 2000 and 2018.Control of acute bleeding,variceal recurrence,rebleeding,eradication and survival were analyzed using Baveno assessment criteria.RESULTS One hundred and forty patients(100 men,40 women;mean age 50 years;range,21-84 years;Child-Pugh grade A=32;B=48;C=60)underwent 160 emergency and 298 elective EVL interventions during a total of 928 endoscopy sessions.One hundred and fourteen(81%)of the 140 patients had variceal bleeding that was effectively controlled during the index banding procedure and never bled again from EV,while 26(19%)patients had complicated and refractory variceal bleeding.EVL controlled the acute sentinel variceal bleed during the first endoscopic intervention in 134 of 140 patients(95.7%).Six patients required balloon tamponade for control and 4 other patients rebled in hospital.Overall 5-d endoscopic failure to control variceal bleeding was 7.1%(n=10)and four patients required a salvage transjugular intrahepatic portosystemic shunt.Index admission mortality was 14.2%(n=20).EV were completely eradicated in 50 of 111 patients(45%)who survived>3 mo of whom 31 recurred and 3 rebled.Sixteen(13.3%)of 120 surviving patients subsequently had 21 EV rebleeding episodes and 10 patients bled from other sources after discharge from hospital.Overall rebleeding from all sources after 2 years was 21.7%(n=26).Sixty-nine(49.3%)of the 140 patients died,mainly due to liver failure(n=46)during follow-up.Cumulative survival for the 140 patients was 71.4%at 1 year,65%at 3 years,60%at 5 years and 52.1%at 10 years.CONCLUSION EVL was highly effective in controlling the sentinel variceal bleed with an overall 5-day failure to control bleeding of 7.1%.Although repeated EVL achieved complete variceal eradication in less than half of patients with BEV,of whom 62%recurred,there was a significant reduction in subsequent rebleeding. | Jake Krige Eduard Jonas Urda Kotze Christo Kloppers Karan Gandhi Hisham Allam Marc Bernon Sean Burmeister Mashiko Setshedi | 2020 | World Journal of Gastrointestinal Endoscopy2020，12，10： | 10 |
| 2 | Packing for Control of Hemorrhage in Major Liver Trauma显示文摘 | A. J. Nicol M. Hommes R. Primrose P. H. Navsaria J. E. J. Krige | 2007 | World Journal of Surgery2007，，3： | 2 |
| 3 | Damage control surgery显示文摘 | Nicol AJ Navsaria PH Krige JE | 2010 | S Afr J Surg2010，48，1： | 1 |
| 4 | Endoscopic management of bile leaks after laparoscopic cholecystectomy显示文摘 | Chinnery GE Krige JE Bornman PC | 2013 | S Afr J Surg2013，51，4： | 1 |
| 5 | Method of interpolation for geographical information system显示文摘 | OLIVER M WEBSTER A KRIGING R | 1990 | Int J Geographical Information Systems1990，4，： | 1 |
| 6 | Operative management of papillary cystic neoplasms of the pancreas 显示文摘 | Panieri E Krige JE Bornman PC | 1998 | J Am Coll Surg1998，186，3： | 1 |
| 7 | Melanoma in black South Africans 显示文摘 | Hudson DA Krige JE | 1995 | J Am Coil Surg1995，180，： | 1 |
| 8 | 'The Birth of EMBO and the Difficult Road to EMBL' 显示文摘 | Krige J | 2002 | Special issue Studies in History and Philosophy of Biological and Biomedical Sciences2002，33，3： | 1 |
| 9 | Pancreatic injuries after blunt abdominal trauma:an analysis of 110 patients treated at a level 1 trauma centre显示文摘 | Krige JE Kotze UK Hameed M | 2011 | S Afr J Surg2011，49，2： | 1 |
| 10 | Ciliated Hepatic Foregut Cyst: A Rare Cystic Liver Lesion显示文摘 | J. M. Shaw J. E. J. Krige S. J. Beningfield M. L. Locketz | 2008 | Journal of Gastrointestinal Surgery2008，，7： | 1 |
| 11 | Closed degloving injuries ~ results following conservative surgery 显示文摘 | Hudson DA Knottenbelt JD Krige JE | 1992 | Plast Reeonstr Surg1992，89，5： | 1 |
| 12 | Severe necrotic pancreatitis caused by organophosphate poisoning显示文摘 | Panieri E Krige JE Bornman PC | 1997 | J Clin Gastroenterol1997，25，： | 1 |
| 13 | A Statistical Approach to some basic mine valuation problems on the Witwatersrand显示文摘 | Krige | 1951 | Journal of the Chemical and Metallurgical Mining Society of SouthAfrica1951，52，： | 1 |
| 14 | Solid pseudopapillary epithelial neoplasm-a rare but curable pancreatic tumour in young women显示文摘 | Frost M Krige JE Bornman PC | 2011 | S Afr J Surg2011，49，2： | 1 |
| 15 | An analysis of predic- tors of morbidity after stab wounds of the pancreas in 78 consecutive injuries显示文摘 | Krige JE Kotze UK Sayed R | 2014 | Ann R Coil Surg Engl2014，96，6： | 1 |
| 16 | Varieeal rebleeding and recurrence after endoscopic injection sclerotherapy: A Prospective Evaluation in 204 Patients 显示文摘 | Krige JE Bornman PC Goldberg PA | 2000 | Archives of Surgery2000，135，11： | 1 |
| 17 | A study of gold and uranium distribution patterns in the Klerksdorp gold field显示文摘 | Krige D G | 1966 | Geoexploration1966，4，1： | 1 |
| 18 | CpG oligodeoxynucteotides act as adjuvants that switch on T helper 1 (Th1) immunity显示文摘 | CHU R S TARGONI O S KRIGE A M | 1997 | J Exp Med1997，186，10： | 1 |
| 19 | Percutaneous transhepatic self expanding metal stents for palliation of malignant biliary obstruction显示文摘 | Lawson AJ Beningfield SJ Krige JE | 2012 | S Afr J Surg2012，50，3： | 1 |
| 20 | Severa nedrotic pancreatitis caused by organophosphate poisoning 显示文摘 | Panieri E Krige JE Bonnman PC el al | 1997 | J Clin Castroenterot1997，，25： | 1 |
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