Quality standard
Quality statement 7: Band ligation for oesophageal variceal bleeding
Quality statement 7: Band ligation for oesophageal variceal bleeding
Quality statement
People with acute upper gastrointestinal bleeding from oesophageal varices are given band ligation.
Rationale
The use of bands for oesophageal bleeding will stop the bleeding and has significant benefits over the alternative of injection sclerotherapy. The benefits include: improved mortality and a reduction in re-bleeding, numbers of additional procedures needed to control bleeding, total units of blood transfused and number of sessions of treatment needed to eradicate varices.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
Evidence of local arrangements to ensure that people with acute upper gastrointestinal bleeding from oesophageal varices are given band ligation.
Data source: Local data collection.
Process
Proportion of people with acute upper gastrointestinal bleeding from oesophageal varices who receive band ligation.
Numerator – the number of people in the denominator who receive band ligation.
Denominator – the number of people with acute upper gastrointestinal bleeding from oesophageal varices.
Data source: Local data collection. The British Society of Gastroenterology's UK comparative audit of upper gastrointestinal bleeding and the use of blood (2007) shows the number of endoscopic therapeutic procedures, which includes banding.
What the quality statement means for different audiences
Service providers ensure that systems are in place for people with acute upper gastrointestinal bleeding from oesophageal varices to be given band ligation.
Healthcare practitioners perform band ligation in people with acute upper gastrointestinal bleeding from oesophageal varices.
Commissioners ensure that they commission services that give band ligation to people with acute upper gastrointestinal bleeding from oesophageal varices.
People with acute upper gastrointestinal bleeding caused by enlarged veins in the oesophagus (gullet) are given band ligation, a type of elastic band that helps to stop the bleeding.
Source guidance
Acute upper gastrointestinal bleeding in over 16s: management. NICE guideline CG141 (2012, updated 2016), recommendation 1.5.3