ESOPHAGEAL VARICES

EARLY RE-BLEEDING, A COMPARISON OF ENDOSCOPIC SCLEROTHERAPY AND A COMBINATION OF SCLEROTHERAPY AND OCTREOTIDE.

Abstract

A comparative trial was conducted to study the relative efficacy of
endoscopic injection sclerotherapy versus endoscopic injection sclerotherapy plus octreotide with reference to acute
control of bleeding esophageal varices and early re-bleeding. A total of 58 patients equally divided in two groups were
included in this study. Bleeding was controlled in 90% patients in both the groups. In group1 there were 20(68.96%)
males and18(62%) males in group 2. The mean age of the patients under study was 50.62 &50.55 in group 1& 2
respectively. The major proportion of patients was in Child Class B, which comprised of 42(72.41%) in total. Child
Class C was excluded out of study. Twenty-two (75.86%) patients in group 1 were in Child Class B and 7(24%) were
in Child Class A & in group 2 there were 20 (68.96%) patients in Child Class B and 21% were in Class A. Etiology of
cirrhosis was HCV in 41(70.86%) and HBV in 9(15.5%) and other etiologies in remaining patients. In, group 1,HCV
related cirrhosis was seen in 20 (68.96%) and in group 2, this was responsible for cirrhosis in 21(70.68%) of patients.
Patients suffering from HBV related cirrhosis were 5(17.42%) in first group and 4(13.79%) in second group 2. Relatively
less number of patients in group 2, had rebleeding in first week of their in-hospital follow-up i.e. 5 versus 8 patients.
Average number of blood transfusions per patient was 3.86 piants in group 1and 2.45 piants in group 2. The mean
duration of Hospital stay was 8.52 days in group 1 and 7.45 days in group 2. Procedure related complications and in
hospital outcome was almost comparable in two groups. The most common complication was hepatic encephalopathy.
Combining endoscopic therapy with one of the vasoactive agents reduces the chances of early re-bleeding and need
for number of blood transfusions and duration of hospital stay.