Sandwich Method With Or Without Lauromacrogol In The Treatment Of Gastric Variceal Bleeding With Liver Cirrhosis:A Meta-analysis

Objective: To evaluate the efficacy and safety of the modified sandwich method with lauromacrogol in the treatment of gastric variceal bleeding with liver cirrhosis and to compare it with the traditional sandwich method,without lauromacrogol,by meta-analysis.Methods: The Cochrane Library,Pubmed,the China National Knowledge Infrastructure(CNKI),the Chinese Wanfang,and the Chongqing VIP databases were searched to identify Cohort studies comparing modified to traditional sandwich method in the treatment of gastric variceal bleeding with liver cirrhosis(searching from inception to July 2017).The relevant data was analyzed with the Reviewer Manager 5.3.Results: Four studies with a total of 587 patients were included in this meta-analysis.The results showed that in the treatment of gastric variceal bleeding with liver cirrhosis,compared with the traditional sandwich method,the modified sandwich method was associated with a higher gastric varices total effective rate(RR: 1.25,95%CI: 1.10-1.43;P <.001)and a lower re-bleeding rate(RR: 0.71,95% CI:0.54-0.93;P =.01).However,there were no statistically significant differences between the two methods in the rate of hemostasis,pain,ulcer erosion,fever,ectopic embolism,and all-cause mortality.Conclusion: The results of this meta-analysis suggest that the modified sandwich method with lauromacrogol is more effective and safer than the traditional sandwich method without lauromacrogol,but due to the limited amount of samples and studies,more RCT studies are needed to further validate it.