AIM:To assess the effects of propranolol as compared withplacebo on gastrointestinal hemorrhage and total mortalityin cirrhotic patients by using meta analysis of 20 publishedrandomized clinical trials.METHODS:A meta analysis of published randomizedclinical trials was designed.Published articles were selectedfor study based on a computerized MEDLINE and a manualsearch of the bibliographies of relevant articles.Data from20 relevant studies fulfilling the inclusion criteria wereretrieved by means of computerized and manual search.The reported data were extracted on the basis of theintention-to-treat principle,and treatment effects weremeasured as risk differences between propranolol andplacebo.Pooled estimates were computed according to arandom-effects model.We evaluated the pooled efficacyof propranolol on the risk of gastrointestinal hemorrhageand the total mortality.RESULTS:A total of 1 859 patients were included in 20trials,931 in the propranolol groups and 928 as controls.Among the 652 patients with upper gastrointestinal tracthemorrhage,261 patients were treated with propranolol,and 396 patients were treated with placebo or non-treated.Pooled risk differences of gastrointestinal hemorrhage were-18 % [95 % CI,-25 %,-10 %] in all trials,-11% [95 % CI,-21%,-1%] in primary prevention trials,and -25 % [95 %CI,-39 %,-10 %] in secondary prevention trials.A total of440 patients died,188 in propranolol groups and 252 in controlgroups.Pooled risk differences of total death were -7 % [95% CI,-12 %,-3 %] in all trials,-9 % [95 % CI,-18 %,-1%]in primary prevention trials,and -5 % [95 % CI,-9 %,-1%]in secondary prevention trials.CONCLUSION: Propranolol can markedly reduce the risks of both primary and recurrent gastrointestinal hemorrhage, and also the total mortality. AIM: To assess the effects of propranolol as compared with placebo on gastrointestinal hemorrhage and total mortality in cirrhotic patients by using meta analysis of 20 published and ommedized clinical trials. METHODS: A meta analysis of published randomized clinical trials was designed. Published articles were selected for study based on a computerized MEDLINE and a manual search of the bibliographies of relevant articles. Data from 20 relevant studies fulfilling the inclusion criteria were retrieved by means of computerized and manual search. The reported data were extracted on the basis of the intention-to-treat principle, and treatment effects weremeasured as risk differences between propranolol andplacebo.Pooled estimates were computed according to arandom-effects model. We evaluated the pooled efficacyof propranolol on the risk of gastrointestinal hemorrhageand the total mortality. RESULTS: A total of 1 859 patients were included in 20trials, 931 in the propranolol groups and 928 as controls.Among the Of the 652 patients with upper gastrointestinal tract hemorrhage, 261 patients were treated with propranolol, and 396 patients were treated with placebo or non-treated. Pooled risk differences of gastrointestinal hemorrhage were -18% [95% CI, -25%, -10%] in all trials, -11% [95% CI, -21%, -1%] in primary prevention trials, and -25% [95% CI, -39%, -10%] in secondary prevention trials died, 188 in propranolol groups and 252 in control groups. Pooled risk differences of total death were -7% [95% CI, -12%, -3%] in all trials, -9% [95% CI, -18% -1%] in primary prevention trials, and -5% [95% CI, -9%, -1%] in secondary prevention trials. CONCLUSION: Propranolol can markedly reduce the risks of both primary and recurrent gastrointestinal hemorrhage, and also the total mortality.