Therapy

Avoid staple transection of the oesophagus 

Why?

• It leads to fewer rebleeds than sclerotherapy ^a but increases early mortality ^a

Oesophageal staple transection reduces rebleeding but increases mortality

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
bleeding varices not controlled by medication or transfusion a	staple transection of the oesophagus	sclerotherapy	rebleeding at 5 days	38%	69% (29% to 87%)	4 (2 to 10)
recent bleeding oesophageal varices a	oesophagogastric devascularisation with oesophageal transection	sclerotherapy	death at 3 months	2.0%	-900% (-7500% to -31%)	-6 (-18 to -3)