ReviewsAssociation of portal venous system thrombosis with endoscopic variceal treatment: a systematic review and meta-analysisWang, Lea,,b,,*; Guo, Xiaozhonga,,b,,*; Xu, Xiangboa,,*; Philips, Cyriac Abbyc; Primignani, Massimod; Mendez-Sanchez, Nahume; Li, Qianqiana,,b; Zheng, Kexina; Qi, XingshunaAuthor Information aDepartment of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area), Shenyang bPostgraduate College, Dalian Medical University, Dalian, China cThe Liver Unit and Monarch Liver Laboratory, Cochin Gastroenterology Group, Ernakulam Medical Center, Kochi, India dCRC ‘A. M. e A. Migliavacca’ Center for Liver Disease, Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy eLiver Research Unit Medica Sur Clinic and Foundation, Mexico City, Mexico *Le Wang, Xiaozhong Guo, and Xiangbo Xu contributed equally to the writing of this article. Received 20 February 2020 Accepted 9 April 2020 Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website, www.eurojgh.com Correspondence to Xingshun Qi, MD, Department of Gastroenterology, General Hospital of Northern Theater Command (formerly General Hospital of Shenyang Military Area), No. 83 Wenhua Road, Shenyang, China, Tel: +86 18909881019; fax: +86 24 28851113; e-mail: [email protected] European Journal of Gastroenterology & Hepatology: February 2021 - Volume 32 - Issue 2 - p 125-131 doi: 10.1097/MEG.0000000000001774 Buy SDC Metrics Abstract The association of endoscopic variceal treatment (EVT) with the development of portal venous system thrombosis (PVST) in liver cirrhosis remains uncertain. A systematic review and meta-analysis aimed to investigate the incidence of PVST after EVT and to explore the association of EVT with the development of PVST in liver cirrhosis. All relevant studies were searched via the PubMed, EMBASE, and Cochrane Library databases. The incidence of PVST in patients treated with and without EVT was pooled. Risk ratios with 95% confidence intervals (CIs) were calculated. Heterogeneity among studies was calculated. Meta-regression, sensitivity, and subgroup analyses were used to analyze the source of heterogeneity. Thirteen studies involving a total of 833 patients were included. The pooled incidence of PVST after EVT was 10.4% (95% CI, 4.9–17.7%). There was a statistically significant heterogeneity (I2 = 83.3%, P < 0.0001). Meta-regression, sensitivity, and subgroup analyses did not find the source of heterogeneity. Four studies compared the incidence of PVST between patients treated with and without EVT. The incidence of PVST was significantly higher in the EVT group than that in the no-EVT group (risk ratio: 2.23; 95% CI, 1.11–4.49; P = 0.02). The heterogeneity was not statistically significant (I2 = 0%, P = 0.43). In conclusion, PVST after EVT may not be scare, and EVT may increase the risk of PVST in liver cirrhosis. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.