Therapy

Perform endoscopic ligation ^a

Why?

• It is more effective than sclerotherapy at reducing rebleeding, death (particularly from bleeding) ^a
• It causes fewer oesophageal strictures ^a
• Fewer sessions are required to achieve variceal obliteration (on average 2 fewer) ^a

Bleeding varices: endoscopic ligation reduces rebleeding and death better than sclerotherapy

Patient	Treatment	Comparison	Outcome	CER	OR (95% CI)	NNT (95% CI)
bleeding oesophageal varices a	endoscopic ligation	sclerotherapy	rebleeding	47%	0.52 (0.37 to 0.74)	7 (5 to 14)
			death	32%	0.67 (0.46 to 0.98)	12 (7 to 230)
			death from rebleeding	14%	0.49 (0.24 to 0.996)	15 (10 to 2100)
			oesophageal strictures	11%	0.10 (0.03 to 0.29)	10 (9 to 13)