Comparison of betablockers and endoscopic variceal band ligation (EVBL) for secondary prevention of variceal bleed in cirrhotics.

Abstract

Objective: To compare the efficacy of pharmacological and endoscopic procedures (band ligation) in preventing variceal bleed. Study Design: Randomized Control Trial. Setting: MU-I of Allied Hospital Faisalabad. Period: January to June 2020. Material & Methods: 80 patients were enrolled after fulfilling exclusion and inclusion criteria, divided into two groups. Group A, patients treated Carvedilol 6.25-12.5mg pulse rate of 60-70 beats per minute. Group B patients underwent repeated endoscopic procedures (band ligation), repeated every 2 weeks until obliteration of varices was achieved. Surveillance endoscopy was done one month later. Follow up was done by telephonic contact at 3 months. Results: In our study, mean age was 52.88+9.29 and 53.57+8.85 years in Group-A and B, 42.5%(n=17) in Group-A and 50%(n=20) in Group-B were male, 57.5%(n=23) in Group-A and 50%(n=20) female in group B, Recurrence of variceal bleeding and efficacy of drug comparison showed that 7.5%(n=3) in Group-A and 27.5%(n=11) in Group-B had a recurrence of variceal bleed while 92.5%(n=37) in Group-A and 72.5%(n=29) in Group-B had no recurrence of variceal bleed, p-value (0.01) was significant. Conclusion: Beta-blocker (Carvedilol) is more efficacious for preventing recurrence of variceal bleed than Endoscopic Band Ligation.