Topic: Oral and Gastrointestinal
Conditions
Interventions
Children will be randomised to:
1. Prophylactic band ligation:
Ligation will be carried out under anaesthesia according to local practice using a multiband ligator. Bands will be applied to all varic
2 - 12 years, 500 mg
greater than 12 years, 1 g). Other antiacid treatment will be according to local practice.
Endoscopy will be repeated after 3 months and at 6 monthly intervals until all varices are ablated or decrea
Sponsors
British Society of Paediatric Gastroenterology Hepatology and Nutrition (BSPGHAN) (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Aged less than or equal to 16 years, either sex 2. Large oesophageal varices 3. No previous variceal bleed 4. Variceal band ligation feasible
Exclusion criteria
Exclusion criteria: 1. Previous endoscopic treatment for portal hypertension 2. Drug treatment for portal hypertension within previous 3 months 3. Anticipated need for liver transplantation or surgery for portal hypertension within 3 months 4. Presence of severe coagulopathy (international normalised ratio [INR] greater than 2.5 and/or platelets less than 50 x 10^9/L)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Oesophageal variceal haemorrhage, defined as malena and/or haematemesis together with either: 1. Endoscopic visualization of blood emanating from oesophageal varices, or 2. The presence of varices together with blood in the stomach and no other source of identifiable bleeding | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Other causes of gastrointestinal bleeding 2. Death due to variceal bleeding | — |
Countries
United Kingdom
Outcome results
None listed