EBL vs. β-Blockers for Preventing Variceal Hemorrhage

Current guidelines recommend β-blockers to prevent variceal hemorrhage in cirrhotic patients with medium or large esophageal varices that have never bled. Several studies and meta-analyses in this population have shown that endoscopic band ligation (EBL) is as effective as, or superior to, β-blocker therapy in preventing first variceal hemorrhage,

but that EBL has no effect on survival. However, several randomized, controlled trials have been published since the last meta-analysis, leading researchers to conduct an updated analysis.

This meta-analysis included data from nine studies published between 1995 and 2006, involving 734 patients who had esophageal varices, secondary to portal hypertension, with no evidence of previous bleeding. Inclu…