Bleeding from esophageal and gastric varices remains one of the most devastating complications of end-stage liver disease, accounting for approximately 80% of upper gastrointestinal bleeding episodes. Bleeding risk is markedly increased in decompensated cirrhosis because 60% of patients have varices and a concomitant reduction in clothing factors is often present. Recent advances in pharmacologic management and endoscopic techniques have improved the capacity to control active bleeding and reduce the risk of rebleeding. Improvements in patient survival have been more difficult to demonstrate; variceal hemorrhage continues to carry a mortality of 30-50%.
Somastostatin is a ubiquitous tetradecapeptide hormone. In most experimental studies, both in animals and in humans, it has reduced protal blood flow, while the effect on intraesophageal pressure has been more equivocal. Somastostatin and its derivative octreotide are often used for emergency treatment of bleeding oesophageal varices in patients with cirrhosis of the liver.
In order to further estimate more precisely the efficacy of somastostatin in the control of bleeding esophageal varices, a meta-analysis is performed based on the results of published trials.
To carry out a meta-analysis to assess the effect of somatostatin in the control of bleeding esophageal varices.
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