Sucralfate for the prevention of early rebleeding following injection sclerotherapy for esophageal varices

✍ Scribed by Rex J. Polson; David Westaby; Alexander E. S. Gimson; Peter C. Hayes; Anthony J. Stellon; Karen Hayllar; Roger Williams

• Publisher: John Wiley and Sons
• Year: 1989
• Tongue: English
• Weight: 419 KB
• Volume: 10
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.1840100304

✦ Synopsis

One hundred eighty patients with variceal bleeding and treated by long-term sclerotherapy were randomized into a prospective randomized controlled clinical trial to assess the efficacy of sucralfate in reducing the frequency of rebleeding from esophageal ulceration prior to variceal obliteration. Overall, 29 (32%) of the 92 patients treated with the addition of sucralfate rebled, compared to 37 (42%) of 88 patients managed by sclerotherapy alone (p c 0.10), but when patients with well-compensated liver disease were considered, the respective figures were 14 (24%) and 25 (42%)-a statistically significant difference (p c 0.05). The frequency (-70%), number (per patient) and extent of sclerotherapy-induced esophageal mucosal ulceration were not different for the two groups, although proven rebleeding from the ulceration occurred less frequently in those receiving sucralfate (10 and 20 occasions, respectively, p < 0.05). Mortality was not different for the two groups. Thus, use of sucralfate will reduce the frequency of rebleeding during long-term treatment by sclerotherapy, although benefit appears to be restricted to wellcompensated patients and without an endoscopic overt effect upon esophageal mucosal ulceration.