Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Double Blind Randomized Placebo-Controlled Trial of Somatostatin in Association With Endoscopic Variceal Ligation (EVL) in Control of Acute Variceal Bleeding
Brief Summary: Background: Efficacy of endoscopic variceal sclerotherapy in achieving initial control of acute variceal bleeding and five-day haemostasis has been shown to significantly improve when vasoactive drug is added. However, there is limited data whether addition of somatostatin, to endoscopic variceal ligation (EVL) improves the efficacy of EVL.

Aim: To compare EVL plus somatostatin versus EVL plus placebo in control of acute variceal bleeding.

Patients and methods: Consecutive cirrhotic patients with acute variceal bleeding from esophageal varices were enrolled in the trial. After emergency EVL, patients were randomized to receive either somatostatin (250 mcg/hr) or placebo infusion. Primary endpoint was treatment failure within 5 days. Treatment failure was defined as fresh hematemesis ≥2 hour after start of therapy or death.


Options:
A: Inclusion Criteria:

* clinically and/or pathologically diagnosed cirrhosis
* with a clinical history of acute variceal bleeding (melena, hematemesis etc.) assessed as Child-Pugh class B or C
* voluntarily participated in the study and able to provide written informed consent and able to understand and willing to comply with the requirements of the study

Exclusion Criteria:

* pregnant or lactating woman
* diagnosed or suspected malignancy (hepatocellular carcinoma, cholangiocarcinoma etc.)
* with mental disease and unable to comply with MRI examination
* with contraindications of terlipressin and octreotide
* with other conditions judged inadequate for participation by the investigators.
B: Inclusion Criteria:

* Clinical diagnosis of portal hypertension
* Having hematemesis and/or melena within 24 hour prior to admission
* Source of bleeding should be esophageal varices

Exclusion Criteria:

* Non-cirrhotic cause of portal hypertension
* Age \<12 or \>75 years
* Hepatic encephalopathy grade 3 or 4
* Renal failure with serum creatinine \>2 mg/dL
* Any evidence of bleeding from additional source apart from esophageal varices (like gastric varices, portal hypertensive gastropathy, erosions or ulcers including variceal ulcers)
* Patients already on vasoactive drugs like somatostatin or terlipressin during the current episode of bleeding
* Patients already received EVL or EST elsewhere during the current episode of bleeding prior to presenting to our hospital
* Patients with history of surgery for portal hypertension or TIPS
* Concomitant severe cardio-pulmonary disease
* Concomitant malignancy
* HVPG not possible within 24 hrs of presentation
* Patients refusing to participate in the study.
C: Inclusion Criteria:

* Adult patients with liver cirrhosis or stigmata of chronic liver disease presenting with hematemesis and or melena within previous 12 hours with
* Age \>18 years
* Informed consent
* Hemodynamically stable patient at the time of endoscopy after resuscitation.

Exclusion Criteria:

* Known allergy to erythromycin
* Prior gastric lavage on admission
* Current use of antiarrhythmic drugs
* Prior gastric surgery
* Previous history of cardiac arrhythmias
* Concomitant use of antihistaminic drugs with possible drug interactions with erythromycin
* Prior use of other prokinetic agents
* Pregnancy or lactation
D: Inclusion Criteria:

* All patients with acute upper GI hemorrhage who do not have any criterion of exclusion.

Exclusion Criteria:

* \< 18 years old.
* Pregnancy.
* Negative of the patient to receive transfusions.
* Negative of the patient to participate in the study.
* Patients with therapeutic restrictions (as terminally ill patients).
* Previous recent surgery requiring transfusion.
* Recent (less than 90 days) or unstable acute myocardic ischemia. Peripheral vasculopathy with secondary.
* To have been included in this same study in the 30 previous days.

Answer: B