The primary objective was to determine the rebleeding rate of TAE compared with surgery. The

secondary objectives were to determine the all-cause mortality rate of TAE compared with surgery and the requirement of additional interventions to secure hemostasis. Methods: SEARCH METHODS Selleckchem MG-132 Computerized medical literature searches were initiated through databases from January 1950 up to January 2013 using OVID MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and systematic, Data-base of Abstracts of Reviews of Effects using a combination of text and MeSH terms.SELECTION CRITERIA All studies comparing TAE with surgery for treatment of NVUGIB uncontrolled by endoscopy were included. Studies were excluded which did not include a comparative group that contained surgery as a form of intervention, because a meta-analysis is not appropriate if the studies did not have a comparative arm. DATA COLLECTION AND ANALYSIS The eligibility and quality of the studies were assessed independently by two investigators. Data was pooled by random-effect model; risk ratio

(RR) was used as a summary statistic. Chi-squared, and I-squared this website tests were used to study heterogeneity between trials. Results: MAIN RESULTS In this review, 6 retrospective comparative studies were included. In these studies, 423 patients were compared, of whom 182 patients underwent TAE (54% male) and 241 patients received surgery (70% male). Patients who underwent TAE were older (mean age; TAE = 75, surgery = 68). Report of active extravasation of contrast seen during TAE ranged from 33% to 42% (2 studies, 55 patients), and routine embolization without angiographic presence of continuing bleeding was described in 5 of 6 studies. High technical success rate of TAE was reported (90% to100%, 5 studies, 142 patients) with low level of TAE related complications (5% to 9.3%, 5 studies, 158 patients). The pooled relative risk (6 studies, 423 patients) showed a significantly higher risk of rebleeding in patients who received TAE compared to those treated surgically (RR = 1.82, 95% CI = 1.23

-2.67), with no statistically significant heterogeneity among the included studies (p = 0.66, I-squared = 0.0%). filipin The pooled results (5 studies, 377 patients) showed no statistically significant difference in requirement of additional interventions in the TAE group compared to surgery (RR = 1.67, 95 % CI = 0.75 -3.70). Although the test for heterogeneity produced a P value of 0.08, I-squared was 52.9%, suggesting moderate heterogeneity. There was no statistical significant difference in mortality rate following TAE compared to the surgery (RR = 0.87, 95 % CI = 0.59 -1.29), with no statistically significant heterogeneity between the studies (p = 0.67, I-sqaured = 0.0%). Conclusion: CONCLUSION Limitation of the meta-analysis was the absence of randomized controlled studies comparing TAE and surgery. Furthermore, the number of comparative studies comparing TAE and surgery were small.