For a study, researchers sought to investigate the frequency of bleeding from ulcers brought on by premature band slippage and find any possible contributing factors. They conducted a record review using a retrospective methodology on patients diagnosed with esophageal varices and treated with endoscopic hemostasis by band ligation (BL) at our facility between 2015 and 2020. They compared patients who had bleeding after a BL ulcer and those who did not (controls). The progression of BL-induced ulcer bleeding served as the outcome variable in this study. Independent variables included a patient’s demographic information, clinical and laboratory characteristics, and the BL procedure’s parameters. To determine potentially related factors based on the odds ratio (OR), univariate and then multivariate logistic regressions were carried out. The findings showed that out of the 4,579 individuals who were eligible for the study, 388 (8.5%) presented with post-BL ulcer hemorrhage. A greater number of varices was related to an increased risk of post-BL ulcer bleeding [OR=1.184 (95% CI: 1.073-1.307)], and the presence of high-risk stigmata indicated 1.271 times higher risk of bleeding [95% CI:1.018-1.587]. On the other hand, using a lower number of bands at each variceal location was related to a lower risk of bleeding [OR=1.308 (95% CI: 1.090-1.569)]. In a univariate analysis, the proton pump inhibitor was found to be protective, with an odds ratio of 0.770 (95% CI: 0.603-0.983); yet, the difference was not shown to be statistically significant after multivariate analysis [OR=1.283 (95% CI: 1.003-1.640)]. The overall incidence of post-BL ulcer bleeding was 8.5%, as was determined in the conclusions. An increased risk of post-BL bleeding was shown to be associated with high-risk stigmata, a higher number of varices, and bands at each variceal site. It was shown that the effect of the proton pump inhibitors in the adjuvant did not reach statistical significance.

SOURCE – journals.lww.com/jcge/Abstract/2022/08000/Bleeding_From_Band_Ligation_induced_Ulcers.13.aspx