<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT02256046</url>
  </required_header>
  <id_info>
    <org_study_id>esophageal ulcers</org_study_id>
    <nct_id>NCT02256046</nct_id>
  </id_info>
  <brief_title>Predictive Factors and Outcome of Esophageal Ulcers After Endoscopic Treatment of Esophageal Varices</brief_title>
  <official_title>Predictive Factors and Outcome of Esophageal Ulcers After Endoscopic Treatment of Esophageal Varices; Multicenter Study</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Tanta University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Tanta University</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
  </oversight_info>
  <brief_summary>
    <textblock>
      Aim of this thesis is to predict the incidence of esophageal ulcer bleeding after endoscopic&#xD;
      management of esophageal varices.&#xD;
&#xD;
      This study will be in the department of Tropical Medicine and Infectious Diseases, Tanta&#xD;
      University, in at least six months in the period from august 2014 to march 2015 or until the&#xD;
      target number of patients reached whichever is longer.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Portal hypertension is a common clinical syndrome, defined by a pathologic increase in the&#xD;
      portal venous pressure, in which the hepatic venous pressure gradient (HVPG) is increased&#xD;
      above normal values (1-5 mmHg). In cirrhosis, portal hypertension results from the&#xD;
      combination of increased intrahepatic vascular resistance and increased blood flow through&#xD;
      the portal venous system.&#xD;
&#xD;
      Esophageal variceal bleeding is one of the most serious complications of portal hypertension,&#xD;
      and represents a leading cause of death in patients with cirrhosis. Each bleeding episode is&#xD;
      associated with a 30% mortality rate.&#xD;
&#xD;
      Endoscopic therapies for varices aim to reduce variceal wall tension by obliteration of the&#xD;
      varix. The two principal methods available for esophageal varices are endoscopic&#xD;
      sclerotherapy (EST) and band ligation (EBL). Endoscopic therapy is a local treatment that has&#xD;
      no effect on the pathophysiological mechanisms that lead to portal hypertension and variceal&#xD;
      rupture. However, a spontaneous decrease in HVPG occurs in around 30% of patients treated&#xD;
      with either EST or EBL to prevent variceal rebleeding. EST consists of the injection of a&#xD;
      sclerosing agent into the variceal lumen or adjacent to the varix, with flexible catheter&#xD;
      with a needle tip, inducing thrombosis of the vessel and inflammation of the surrounding&#xD;
      tissues. During active bleeding, sclerotherapy may achieve hemostasis, inducing variceal&#xD;
      thrombosis and external compression by tissue edema. With repeated sessions, the inflammation&#xD;
      of the vascular wall and surrounding tissues leads to fibrosis, resulting in variceal&#xD;
      obliteration.&#xD;
&#xD;
      Furthermore, vascular thrombosis may induce ulcers that also heal, inducing fibrosis. There&#xD;
      are technical variations in performing EST, such as type and concentration of the&#xD;
      sclerosants, volume injected, interval between sessions, and number of sessions Endoscopic&#xD;
      band ligation (EBL) is generally accepted as the treatment of choice for bleeding from&#xD;
      esophageal varices. It has shown good results in terms of the control of the active bleeding,&#xD;
      with few untoward effects.&#xD;
&#xD;
      Esophageal ulcerations ulcerations occur in the esophageal mucosa after all successful&#xD;
      ligations. However, ulcers following Esophageal Variceal Ligation (EVL) are less severe than&#xD;
      with ES.&#xD;
&#xD;
      Aim of this thesis is to predict the incidence of esophageal ulcer bleeding after endoscopic&#xD;
      management of esophageal varices.&#xD;
&#xD;
      . This study will be in the department of Tropical Medicine and Infectious Diseases, Tanta&#xD;
      University, in at least six months in the period from august 2014 to march 2015 or until the&#xD;
      target number of patients reached whichever is longer.&#xD;
&#xD;
      The study include more than 224 patients who undergo endoscopic management of esophageal&#xD;
      varices:&#xD;
&#xD;
      Methods:&#xD;
&#xD;
      All patients will be subjected to:&#xD;
&#xD;
        -  full history taking.&#xD;
&#xD;
        -  -complete clinical examination.&#xD;
&#xD;
        -  -investigations for all groups: i) Complete Blood Count (CBC) ii) liver function tests&#xD;
           iii) Kidney function tests. iv) ultrasound on abdomen and pelvis&#xD;
&#xD;
        -  Upper endoscopy at day 0 , follow up endoscopy at day 14 and at 6months&#xD;
&#xD;
      End points:&#xD;
&#xD;
        1. ry end point:at 14 days to look for and characterize ulcer if any&#xD;
&#xD;
        2. ry end point: at 6months to look for general and local outcome of intervention&#xD;
&#xD;
      Inclusion criteria:&#xD;
&#xD;
      Patient with esophageal varices having upper GIT endoscopy&#xD;
&#xD;
      Exclusion criteria:&#xD;
&#xD;
      Patients having endoscopy with no esophageal varices (EVs)&#xD;
&#xD;
      ETHICAL CONSIDERATIONS Unexpected risks during the course of the research will be cleared to&#xD;
      the participants and the ethical committee on time , thrombophlebitis may occur during taking&#xD;
      blood sample, the investigators will use sterilized techniques during taking sample also&#xD;
      bleeding from pinpoint needle track could happen , the investigators will do needle track&#xD;
      ablation to avoid it. The investigators will use sterilized techniques during taking sample.&#xD;
&#xD;
      Informed consent will be taken and everyone will be given a coded number . Names will not be&#xD;
      mentioned ,no pictures will be taken to any part of the body. Results of investigations will&#xD;
      be collected, tabulated and statistically analyzed for scientific purposes only.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Recruiting</last_known_status>
  <start_date>August 2014</start_date>
  <completion_date type="Anticipated">March 2015</completion_date>
  <primary_completion_date type="Anticipated">March 2015</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>N/A</allocation>
    <intervention_model>Single Group Assignment</intervention_model>
    <primary_purpose>Screening</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Incidence of esophageal ulcer bleeding after endoscopic management of esophageal varices.</measure>
    <time_frame>6 months</time_frame>
  </primary_outcome>
  <number_of_arms>1</number_of_arms>
  <enrollment type="Anticipated">224</enrollment>
  <condition>Esophageal and Gastric Varices</condition>
  <condition>Ulcer</condition>
  <condition>Cirrhosis</condition>
  <condition>Hypertension, Portal</condition>
  <arm_group>
    <arm_group_label>Esophagogastroduodenoscope</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Endoscopic therapies for varices aim to reduce variceal wall tension by obliteration of the varix. The two principal methods available for esophageal varices are endoscopic sclerotherapy (EST) and band ligation (EBL). Endoscopic therapy is a local treatment that has no effect on the pathophysiological mechanisms that lead to portal hypertension and variceal rupture. However, a spontaneous decrease in HVPG occurs in around 30% of patients treated with either EST or EBL to prevent variceal rebleeding.</description>
  </arm_group>
  <intervention>
    <intervention_type>Device</intervention_type>
    <intervention_name>Esophagogastroduodenoscope</intervention_name>
    <description>Endoscopic therapies for varices aim to reduce variceal wall tension by obliteration of the varix. The two principal methods available for esophageal varices are endoscopic sclerotherapy (EST) and band ligation (EBL). Endoscopic therapy is a local treatment that has no effect on the pathophysiological mechanisms that lead to portal hypertension and variceal rupture. However, a spontaneous decrease in HVPG occurs in around 30% of patients treated with either EST or EBL to prevent variceal rebleeding.</description>
    <arm_group_label>Esophagogastroduodenoscope</arm_group_label>
    <other_name>EGD, upper GI endoscopy</other_name>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Patient with esophageal varices having upper GIT endoscopy&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Patients having endoscopy with no EVs&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>70 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Asem A Elfert, MD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Tanta Faculty of Medicine, Professor</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Fat-heya E Assel, MD'</last_name>
    <role>Study Director</role>
    <affiliation>Tanta Faculty of Medicine, Professor</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Ferial Elkalla, MD</last_name>
    <role>Study Director</role>
    <affiliation>Tanta Faculty of Medicine, Professor</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Galal Elkassas, MD</last_name>
    <role>Study Director</role>
    <affiliation>Tanta Faculty of Medicine, Professor</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Mohamed Elhendawy</last_name>
    <role>Study Director</role>
    <affiliation>Dr.</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Loai Mansour</last_name>
    <role>Study Director</role>
    <affiliation>Dr.</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Mohamed Rabei</last_name>
    <role>Study Director</role>
    <affiliation>Dr.</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Samah Mosaad</last_name>
    <role>Study Director</role>
    <affiliation>Dr.</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Ibrahim A Kabbash, MD</last_name>
    <role>Study Director</role>
    <affiliation>Tanta Faculty of Medicine, Professor</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Mohamed Elkassas</last_name>
    <role>Study Director</role>
    <affiliation>Dr.</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Islam S Ismail</last_name>
    <role>Study Director</role>
    <affiliation>Dr.</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Ibrahim Shebl</last_name>
    <role>Study Director</role>
    <affiliation>Dr.</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Asem A Elfert, MD</last_name>
    <phone>+20-122-437-8188</phone>
    <email>asem1967@yahoo.com</email>
  </overall_contact>
  <location>
    <facility>
      <name>Tanta University Hospital</name>
      <address>
        <city>Tanta</city>
        <state>Gharbia</state>
        <zip>31111</zip>
        <country>Egypt</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Asem A Elfert, MD</last_name>
      <phone>+20-122-437-8188</phone>
      <email>asem1967@yahoo.com</email>
    </contact>
    <investigator>
      <last_name>Asem A Elfert, MD</last_name>
      <role>Principal Investigator</role>
    </investigator>
    <investigator>
      <last_name>Fat-heya E Assel, MD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Ferial Elkalla, MD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Galal Elkassas, MD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Mohamed Elhendawy</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Loai Mansour</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Mohamed Rabei</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Samah Mosaad</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Ibrahim Kabbash, MD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Mohamed Elkassas</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Islam S Ismail</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Ibrahim Shebl</last_name>
      <role>Sub-Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>Egypt</country>
  </location_countries>
  <results_reference>
    <citation>Rigau J, Bosch J, Bordas JM, Navasa M, Mastai R, Kravetz D, Bruix J, Feu F, Rodes J. Endoscopic measurement of variceal pressure in cirrhosis: correlation with portal pressure and variceal hemorrhage. Gastroenterology. 1989 Mar;96(3):873-80.</citation>
    <PMID>2783677</PMID>
  </results_reference>
  <results_reference>
    <citation>Garcia-Tsao G, Groszmann RJ, Fisher RL, Conn HO, Atterbury CE, Glickman M. Portal pressure, presence of gastroesophageal varices and variceal bleeding. Hepatology. 1985 May-Jun;5(3):419-24. doi: 10.1002/hep.1840050313.</citation>
    <PMID>3873388</PMID>
  </results_reference>
  <results_reference>
    <citation>Cales P, Pascal JP. [Natural history of esophageal varices in cirrhosis (from origin to rupture)]. Gastroenterol Clin Biol. 1988 Mar;12(3):245-54. No abstract available. French.</citation>
    <PMID>3286356</PMID>
  </results_reference>
  <results_reference>
    <citation>de Franchis R. Endoscopy critics vs. endoscopy enthusiasts for primary prophylaxis of variceal bleeding. Hepatology. 2006 Jan;43(1):24-6. doi: 10.1002/hep.21026. No abstract available.</citation>
    <PMID>16374843</PMID>
  </results_reference>
  <results_reference>
    <citation>Garcia-Pagan JC, De Gottardi A, Bosch J. Review article: the modern management of portal hypertension--primary and secondary prophylaxis of variceal bleeding in cirrhotic patients. Aliment Pharmacol Ther. 2008 Jul;28(2):178-86. doi: 10.1111/j.1365-2036.2008.03729.x. Epub 2008 May 2.</citation>
    <PMID>18462268</PMID>
  </results_reference>
  <results_reference>
    <citation>Villanueva C, Lopez-Balaguer JM, Aracil C, Kolle L, Gonzalez B, Minana J, Soriano G, Guarner C, Balanzo J. Maintenance of hemodynamic response to treatment for portal hypertension and influence on complications of cirrhosis. J Hepatol. 2004 May;40(5):757-65. doi: 10.1016/j.jhep.2004.01.017.</citation>
    <PMID>15094222</PMID>
  </results_reference>
  <results_reference>
    <citation>Villanueva C, Colomo A, Aracil C, Guarner C. Current endoscopic therapy of variceal bleeding. Best Pract Res Clin Gastroenterol. 2008;22(2):261-78. doi: 10.1016/j.bpg.2007.11.012.</citation>
    <PMID>18346683</PMID>
  </results_reference>
  <results_reference>
    <citation>de Franchis R, Primignani M. Endoscopic treatments for portal hypertension. Semin Liver Dis. 1999;19(4):439-55. doi: 10.1055/s-2007-1007131.</citation>
    <PMID>10643628</PMID>
  </results_reference>
  <results_reference>
    <citation>Westaby D. Emergency and elective endoscopic therapy for variceal haemorrhage. Baillieres Clin Gastroenterol. 1992 Sep;6(3):465-80. doi: 10.1016/0950-3528(92)90033-b. No abstract available.</citation>
    <PMID>1421595</PMID>
  </results_reference>
  <results_reference>
    <citation>Villanueva C, Sancho-Poch F, Balanz Jea. Esophagic Histophathologic changes induced by variceal sclerosing therapy. Gastroenterol Hepatol 1990; 13: 15-19</citation>
  </results_reference>
  <results_reference>
    <citation>Helmy A, Hayes PC. Review article: current endoscopic therapeutic options in the management of variceal bleeding. Aliment Pharmacol Ther. 2001 May;15(5):575-94. doi: 10.1046/j.1365-2036.2001.00950.x.</citation>
    <PMID>11328251</PMID>
  </results_reference>
  <results_reference>
    <citation>Young MF, Sanowski RA, Rasche R. Comparison and characterization of ulcerations induced by endoscopic ligation of esophageal varices versus endoscopic sclerotherapy. Gastrointest Endosc. 1993 Mar-Apr;39(2):119-22. doi: 10.1016/s0016-5107(93)70049-8.</citation>
    <PMID>8495829</PMID>
  </results_reference>
  <verification_date>October 2014</verification_date>
  <study_first_submitted>September 26, 2014</study_first_submitted>
  <study_first_submitted_qc>September 30, 2014</study_first_submitted_qc>
  <study_first_posted type="Estimate">October 3, 2014</study_first_posted>
  <last_update_submitted>October 2, 2014</last_update_submitted>
  <last_update_submitted_qc>October 2, 2014</last_update_submitted_qc>
  <last_update_posted type="Estimate">October 6, 2014</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Tanta University</investigator_affiliation>
    <investigator_full_name>Ibrahim Shebl</investigator_full_name>
    <investigator_title>Dr.</investigator_title>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Esophageal and Gastric Varices</mesh_term>
    <mesh_term>Hypertension, Portal</mesh_term>
    <mesh_term>Varicose Veins</mesh_term>
    <mesh_term>Ulcer</mesh_term>
  </condition_browse>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT02256046
org study id: esophageal ulcers
nct id: NCT02256046
lead sponsor: 
has dmc: Yes
Aim of this thesis is to predict the incidence of esophageal ulcer bleeding after endoscopic
      management of esophageal varices.

      This study will be in the department of Tropical Medicine and Infectious Diseases, Tanta
      University, in at least six months in the period from august 2014 to march 2015 or until the
      target number of patients reached whichever is longer.
Portal hypertension is a common clinical syndrome, defined by a pathologic increase in the
      portal venous pressure, in which the hepatic venous pressure gradient (HVPG) is increased
      above normal values (1-5 mmHg). In cirrhosis, portal hypertension results from the
      combination of increased intrahepatic vascular resistance and increased blood flow through
      the portal venous system.

      Esophageal variceal bleeding is one of the most serious complications of portal hypertension,
      and represents a leading cause of death in patients with cirrhosis. Each bleeding episode is
      associated with a 30% mortality rate.

      Endoscopic therapies for varices aim to reduce variceal wall tension by obliteration of the
      varix. The two principal methods available for esophageal varices are endoscopic
      sclerotherapy (EST) and band ligation (EBL). Endoscopic therapy is a local treatment that has
      no effect on the pathophysiological mechanisms that lead to portal hypertension and variceal
      rupture. However, a spontaneous decrease in HVPG occurs in around 30% of patients treated
      with either EST or EBL to prevent variceal rebleeding. EST consists of the injection of a
      sclerosing agent into the variceal lumen or adjacent to the varix, with flexible catheter
      with a needle tip, inducing thrombosis of the vessel and inflammation of the surrounding
      tissues. During active bleeding, sclerotherapy may achieve hemostasis, inducing variceal
      thrombosis and external compression by tissue edema. With repeated sessions, the inflammation
      of the vascular wall and surrounding tissues leads to fibrosis, resulting in variceal
      obliteration.

      Furthermore, vascular thrombosis may induce ulcers that also heal, inducing fibrosis. There
      are technical variations in performing EST, such as type and concentration of the
      sclerosants, volume injected, interval between sessions, and number of sessions Endoscopic
      band ligation (EBL) is generally accepted as the treatment of choice for bleeding from
      esophageal varices. It has shown good results in terms of the control of the active bleeding,
      with few untoward effects.

      Esophageal ulcerations ulcerations occur in the esophageal mucosa after all successful
      ligations. However, ulcers following Esophageal Variceal Ligation (EVL) are less severe than
      with ES.

      Aim of this thesis is to predict the incidence of esophageal ulcer bleeding after endoscopic
      management of esophageal varices.

      . This study will be in the department of Tropical Medicine and Infectious Diseases, Tanta
      University, in at least six months in the period from august 2014 to march 2015 or until the
      target number of patients reached whichever is longer.

      The study include more than 224 patients who undergo endoscopic management of esophageal
      varices:

      Methods:

      All patients will be subjected to:

        -  full history taking.

        -  -complete clinical examination.

        -  -investigations for all groups: i) Complete Blood Count (CBC) ii) liver function tests
           iii) Kidney function tests. iv) ultrasound on abdomen and pelvis

        -  Upper endoscopy at day 0 , follow up endoscopy at day 14 and at 6months

      End points:

        1. ry end point:at 14 days to look for and characterize ulcer if any

        2. ry end point: at 6months to look for general and local outcome of intervention

      Inclusion criteria:

      Patient with esophageal varices having upper GIT endoscopy

      Exclusion criteria:

      Patients having endoscopy with no esophageal varices (EVs)

      ETHICAL CONSIDERATIONS Unexpected risks during the course of the research will be cleared to
      the participants and the ethical committee on time , thrombophlebitis may occur during taking
      blood sample, the investigators will use sterilized techniques during taking sample also
      bleeding from pinpoint needle track could happen , the investigators will do needle track
      ablation to avoid it. The investigators will use sterilized techniques during taking sample.

      Informed consent will be taken and everyone will be given a coded number . Names will not be
      mentioned ,no pictures will be taken to any part of the body. Results of investigations will
      be collected, tabulated and statistically analyzed for scientific purposes only.
allocation: N/A
intervention model: Single Group Assignment
primary purpose: Screening
masking: None (Open Label)
measure: Incidence of esophageal ulcer bleeding after endoscopic management of esophageal varices.
time frame: 6 months
arm group label: Esophagogastroduodenoscope
arm group type: Experimental
description: Endoscopic therapies for varices aim to reduce variceal wall tension by obliteration of the varix. The two principal methods available for esophageal varices are endoscopic sclerotherapy (EST) and band ligation (EBL). Endoscopic therapy is a local treatment that has no effect on the pathophysiological mechanisms that lead to portal hypertension and variceal rupture. However, a spontaneous decrease in HVPG occurs in around 30% of patients treated with either EST or EBL to prevent variceal rebleeding.
intervention type: Device
intervention name: Esophagogastroduodenoscope
description: Endoscopic therapies for varices aim to reduce variceal wall tension by obliteration of the varix. The two principal methods available for esophageal varices are endoscopic sclerotherapy (EST) and band ligation (EBL). Endoscopic therapy is a local treatment that has no effect on the pathophysiological mechanisms that lead to portal hypertension and variceal rupture. However, a spontaneous decrease in HVPG occurs in around 30% of patients treated with either EST or EBL to prevent variceal rebleeding.
arm group label: Esophagogastroduodenoscope
other name: EGD, upper GI endoscopy
criteria: 
gender: All
minimum age: 18 Years
maximum age: 70 Years
healthy volunteers: No
last name: Asem A Elfert, MD
role: Principal Investigator
affiliation: Tanta Faculty of Medicine, Professor
last name: Fat-heya E Assel, MD'
role: Study Director
affiliation: Tanta Faculty of Medicine, Professor
last name: Ferial Elkalla, MD
role: Study Director
affiliation: Tanta Faculty of Medicine, Professor
last name: Galal Elkassas, MD
role: Study Director
affiliation: Tanta Faculty of Medicine, Professor
last name: Mohamed Elhendawy
role: Study Director
affiliation: Dr.
last name: Loai Mansour
role: Study Director
affiliation: Dr.
last name: Mohamed Rabei
role: Study Director
affiliation: Dr.
last name: Samah Mosaad
role: Study Director
affiliation: Dr.
last name: Ibrahim A Kabbash, MD
role: Study Director
affiliation: Tanta Faculty of Medicine, Professor
last name: Mohamed Elkassas
role: Study Director
affiliation: Dr.
last name: Islam S Ismail
role: Study Director
affiliation: Dr.
last name: Ibrahim Shebl
role: Study Director
affiliation: Dr.
last name: Asem A Elfert, MD
phone: +20-122-437-8188
email: asem1967@yahoo.com
facility: 
status: Recruiting
contact: 
investigator: 
investigator: 
investigator: 
investigator: 
investigator: 
investigator: 
investigator: 
investigator: 
investigator: 
investigator: 
investigator: 
investigator: 
country: Egypt
citation: Rigau J, Bosch J, Bordas JM, Navasa M, Mastai R, Kravetz D, Bruix J, Feu F, Rodes J. Endoscopic measurement of variceal pressure in cirrhosis: correlation with portal pressure and variceal hemorrhage. Gastroenterology. 1989 Mar;96(3):873-80.
PMID: 2783677
citation: Garcia-Tsao G, Groszmann RJ, Fisher RL, Conn HO, Atterbury CE, Glickman M. Portal pressure, presence of gastroesophageal varices and variceal bleeding. Hepatology. 1985 May-Jun;5(3):419-24. doi: 10.1002/hep.1840050313.
PMID: 3873388
citation: Cales P, Pascal JP. [Natural history of esophageal varices in cirrhosis (from origin to rupture)]. Gastroenterol Clin Biol. 1988 Mar;12(3):245-54. No abstract available. French.
PMID: 3286356
citation: de Franchis R. Endoscopy critics vs. endoscopy enthusiasts for primary prophylaxis of variceal bleeding. Hepatology. 2006 Jan;43(1):24-6. doi: 10.1002/hep.21026. No abstract available.
PMID: 16374843
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responsible party type: Principal Investigator
investigator affiliation: Tanta University
investigator full name: Ibrahim Shebl
investigator title: Dr.
mesh term: Esophageal and Gastric Varices
mesh term: Hypertension, Portal
mesh term: Varicose Veins
mesh term: Ulcer