Cross-section Band Ligation Versus Stepladder Band Ligation of Esophageal Varices

NCT ID: NCT06881082

Last Updated: 2025-03-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

320 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-12-01

Study Completion Date

2025-12-30

Brief Summary

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The goal of this randomized controlled trial is to evaluate the cross-section band ligation technique versus the stepladder band ligation technique in esophageal varices prophylaxis.

Researchers will compare cross-section and step ladder band ligation techniques for esophageal varices prophylaxis regarding efficacy, side effects, variceal recurrence, and survival.

Participants will undergo history-taking, clinical examination, laboratory investigations, and upper endoscopy. Index upper endoscopy will be performed to evaluate the presence, size, and grade of esophageal varices. Patients will be randomly assigned to endoscopic band ligation (EBL) either by cross-section or stepladder techniques every two to four weeks until eradication. After eradication of varices, endoscopy will be repeated after 3-6 months to check for variceal recurrence. For a period of 6 months, all patients in the treatment groups will be followed up every 3 months with clinic visits, including laboratory testing, evaluation of treatment-related side effects, bleeding rates, and mortality from EBL treatment.

Detailed Description

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Conditions

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Esophageal Varices

Study Design

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Allocation Method

NA

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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cross-section band ligation

160 cirrhotic patients with endoscopic evidence of medium/large-sized esophageal varices undergoing endoscopic prophylaxis using the cross-section band ligation technique.

Group Type EXPERIMENTAL

endoscopic band ligation with cross-section technique

Intervention Type PROCEDURE

Endoscopic band ligation (EBL) of medium/large-sized esophageal varices using the cross-section banding technique. EBL will be repeated every two to four weeks until eradication. After eradication of varices, endoscopy will be repeated after 3- 6 months to check for variceal recurrence, evaluation of treatment-related side effects, bleeding rates, and mortality from EBL treatment.

stepladder band ligation

160 cirrhotic patients with endoscopic evidence of medium/large-sized esophageal varices undergoing endoscopic prophylaxis using the step ladder band ligation technique.

Group Type ACTIVE_COMPARATOR

Endoscopic band ligation using stepladder technique

Intervention Type PROCEDURE

Endoscopic band ligation (EBL) of medium/large-sized esophageal varices using the stepladder banding technique. EBL will be repeated every two to four weeks until eradication. After eradication of varices, endoscopy will be repeated after 3- 6 months to check for variceal recurrence, evaluation of treatment-related side effects, bleeding rates, and mortality from EBL treatment

Interventions

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endoscopic band ligation with cross-section technique

Endoscopic band ligation (EBL) of medium/large-sized esophageal varices using the cross-section banding technique. EBL will be repeated every two to four weeks until eradication. After eradication of varices, endoscopy will be repeated after 3- 6 months to check for variceal recurrence, evaluation of treatment-related side effects, bleeding rates, and mortality from EBL treatment.

Intervention Type PROCEDURE

Endoscopic band ligation using stepladder technique

Endoscopic band ligation (EBL) of medium/large-sized esophageal varices using the stepladder banding technique. EBL will be repeated every two to four weeks until eradication. After eradication of varices, endoscopy will be repeated after 3- 6 months to check for variceal recurrence, evaluation of treatment-related side effects, bleeding rates, and mortality from EBL treatment

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Aged \>18 years.
* Cirrhotic patients.
* Endoscopic evidence of medium/large-sized esophageal varices.

Exclusion Criteria

* History of variceal bleeding or previous primary prevention of varices.
* Portal vein thrombosis or previous porto-systemic shunts as TIPS.
* Patients on drugs affecting portal pressure (beta blockers, nitrates).
* Advanced cardiovascular disease including acute myocardial infarction, atrio-ventricular block, congestive heart failure, chronic peripheral ischemia, and severe bradycardia.
* Patients with severe respiratory diseases (COPD, bronchial asthma).
* Uncontrolled diabetes mellitus.
* Renal impairment.
* Hepatocellular carcinoma.
* Allergy to carvedilol.
* Pregnancy or lactation.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tanta University

OTHER

Sponsor Role lead

Responsible Party

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Rania Mamdouh Elkafoury

Lecturer of Tropical Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nabila A Elgazzar, MD

Role: PRINCIPAL_INVESTIGATOR

Tropical medicine and infectious diseases Department, Faculty of Medicine, Tanta University

Locations

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Tanta University Hospitals

Tanta, Gharbyea, Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Rania M Elkafoury, MD

Role: CONTACT

+201004672358

Nabila A Elgazzar, MD

Role: CONTACT

00201288585733

Facility Contacts

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Dina H Ziada, MD

Role: primary

00201117109990

Role: backup

Other Identifiers

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36264PR978/12/24

Identifier Type: -

Identifier Source: org_study_id

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