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A prospective randomized trial comparing somatostatin and sclerotherapy in the treatment of acute variceal bleeding

✍ Scribed by Ramon Planas; Juan Carlos Quer; Jaume Boix; Jaume Canet; Manel Armengol; Eduard Cabre; Teresa Pintanel; Pere Humbert; Benjamin Oller; Marc Antoni Broggi; Miquel Angel Gassull

Publisher: John Wiley and Sons
Year: 1994
Tongue: English
Weight: 645 KB
Volume: 20
Category: Article
ISSN: 0270-9139
DOI: 10.1002/hep.1840200216

No coin nor oath required. For personal study only.

✦ Synopsis

Somatostatin and endoscopic sclerotherapy are widely used in the treatment of acute variceal bleeding. Although objective evidence does exist about the advantages of either treatment, data comparing both procedures are scarce. In order to compare the effectiveness and safety of somatostatin and sclerotherapy in the treatment of acute variceal bleeding, 70 consecutive cirrhotic patients suffering from esophageal variceal hemorrhage and meeting the inclusion criteria were randomly assigned to treatment with somatostatin (35 patients) or sclerotherapy (35 patients). No differences in age, sex, alcohol intake, etiology of cirrhosis and severity of liver failure were found between groups. Failure of treatment (defined as persistence of bleeding despite therapy or subsequent rebleeding within the 48-hr trial period) occurred in seven patients (20%) in the somatostatin group and in six (17.1%) in the sclerotherapy group (NS). Early rebleeding occurred in seven of 28 patients (25%) in the somatostatin group and in five of 29 (17.2%) in the sclerotherapy group (NS). Mortality within the first 6 wk was no different between both groups: 10 (28.5%) and eight (22.89) in the somatostatin and sclerotherapy groups, respectively. Sclerotherapy, but not somatostatin, was associated with major complications in five cases (14.2%) (p = 0.026), two of which resulted in patient's death. These results suggest that somatostatin is safer, and as effective as sclerotherapy, in controlling acute variceal bleeding until an elective treatment can be established. (HEPATOLOGY 1994;20: 370-375.) Bleeding from esophageal varices is life-threatening in

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