Endoscopic band ligation is safe despite low platelet count and high INR

Background Prophylactic endoscopic band ligation (EBL) is used to prevent variceal bleeding in patients with liver cirrhosis. The association of thrombocytopenia, high INR (international normalized ratio) and liver dysfunction with the risk of procedure-related bleeding (PRB) remains debated and recommendations are controversial. Methods We analyzed real-life data of cirrhotic patients undergoing elective EBL at two large Viennese centers between Q1/2000–Q1/2018. PRB was defined as bleeding occurring within 30 days after EBL. Results We included 617 patients undergoing a total of 1178 prophylactic EBL procedures (median 2 per patient). Sixteen (2.6%) of 617 patients experienced PRB after a median of 12.5 (IQR 17.3) days with no difference in characteristics and laboratory values between the two groups. The proportion of patients with platelets (PLT) Conclusion EBL is safe and procedure-related bleedings are rare (2.6%) including in patients with thrombocytopenia