Primary prophylaxis of oesophageal variceal bleeding in children by ligation is safe and as efficient as secondary prophylaxis
Résumé
We read with interest the recent study by Dr Duché et al.[1]
about primary prophylaxis. They answer several questions raised by the Baveno consensus workshop. [2]
Based on a high-risk varices pattern (grade 2 and /or varices along the cardia, grade 3, and gastric varices), they treated children with primary prophylaxis by endoscopic treatment, either ligation or sclerotherapy, by portosystemic shunts in patients with and without cirrhosis, and by Meso-Rex bypasses in cases where portal hypertension was not caused by cirrhosis. The ten-year probability of bleeding free survival was 96% and 72% in the non-cirrhotic and cirrhotic groups, respectively. All types of primary prophylaxis were included, and the results suggest that primary prophylaxis of portal hypertension in children is efficient.