BMC Gastroenterol. 2025 Jul 1;25(1):446. doi: 10.1186/s12876-025-04037-0.
ABSTRACT
BACKGROUND: Cirrhosis, a common chronic liver disease, leads to portal hypertension and complications like ascites and variceal bleeding. Endoscopic variceal ligation (EVL) is the preferred treatment for variceal bleeding. Post-EVL rebleeding due to mucosal irritation from gastric reflux significantly impacts patient prognosis. Omeprazole is an acid-suppressing medication to reduce mucosal damage and improve hemostasis. However, the effect of EVL combined with omeprazole in the treatment of esophageal variceal hemorrhage in cirrhosis remains exploring. Therefore, the present study aims to investigate the value of EVL + omeprazole in treating upper gastrointestinal hemorrhage combined with liver cirrhosis.
METHODS: One hundred patients with cirrhosis combined with upper gastrointestinal bleeding (January 2019-December 2022) were included as study subjects. Patients were categorized into observation (50 cases, omeprazole + endoscopic ligation) and control (50 cases, endoscopic ligation) groups. Clinical effects, hemostatic effects, portal venous blood flow, and stress indicators between the two groups were compared.
RESULTS: The blood transfusion volume, hospitalization time, hemostasis time and rebleeding rate of the observation group were statistically lower than control (P < 0.05). The portal vein blood flow and splenic vein blood flow in both groups after treatment were significantly lower than those before treatment (P < 0.05). The total effective rate of observation group was significantly higher than control (94.0% vs. 80.0%, P < 0.05). Also, the expression of serum amyloid A (SAA), IL-6, procalcitonin (PCT), cortisol (Cor), prostaglandin E2 (PGE2) and C-reactive protein (CRP) in observation group were significantly lower than control (P < 0.05).
CONCLUSION: The combination of EVL and omeprazole effectively manages esophagogastric variceal hemorrhage in cirrhotic patients, enhancing hemostasis, reducing rebleeding, and improving portal hemodynamics.
TRIAL REGISTRATION: Not applicable.
CLINICAL TRIAL NUMBER: Not applicable.
PMID:40596836 | PMC:PMC12211526 | DOI:10.1186/s12876-025-04037-0