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[Sclerotherapy of esophageal varices using ethanol in combination with propranolol: clinical study of 30 patients].
Gastroenterol Clin Biol. 1988 Dec; 12(12):899-905.GC

Abstract

A prospective study was conducted in 30 patients to assess the efficacy and safety of endoscopic sclerotherapy with absolute alcohol associated with propranolol for prevention of recurrent variceal bleeding. Patients were included if propranolol alone had failed or if they had at least three factors which increased the risk of rebleeding although the patients were receiving propranolol; two patients were treated by sclerotherapy only because of contraindications to propranolol. Etiology of portal hypertension was cirrhosis in 29 patients and portal vein thrombosis in one patient. Seventeen patients were grade A and 13 were grade B according to Child-Pugh's classification. The cumulative percentage of patients free of rebleeding 12 months after inclusion was 43 +/- 10 p. 100 (m +/- SD). The cause of recurrent bleeding was esophageal varices in nine patients and esophageal ulcers in five patients. The cumulative percentage of variceal rebleeding 12 months after inclusion was 61 +/- 10 p. 100. The cumulative percentages of patients free of rebleeding from varices were not significantly different between the Pugh A (64 +/- 14 p. 100) and Pugh B (56 +/- 15 p. 100) patients. The cumulative percentage of patients surviving 12 months after inclusion was 55 +/- 9 p. 100. The cause of death was not related to sclerotherapy in 11 patients. Two patients died of esophageal wall necrosis associated with mediastinitis. These two patients had received large volumes of sclerosing agent because of important bleeding during the last injection. Our results suggest that in patients without severe cirrhosis who cannot be treated by propranolol alone, the risk of rebleeding and the risk of death are high despite sclerotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Poynard T
Service d'Hépato-Gastroentérologie, Hôpital Antoine-Béclère, Clamart.
Aubert A
No affiliation info available
Naveau S
No affiliation info available
Lemman M
No affiliation info available
Chaput JC
No affiliation info available

MeSH

AgedDrug Therapy, CombinationEsophageal and Gastric VaricesEthanolFemaleGastrointestinal HemorrhageHumansMaleMiddle AgedPropranololProspective StudiesRecurrenceRisk FactorsSclerosing Solutions

Pub Type(s)

English Abstract
Journal Article
Review

Language

fre

PubMed ID

3069544

Citation

Poynard, T, et al. "[Sclerotherapy of Esophageal Varices Using Ethanol in Combination With Propranolol: Clinical Study of 30 Patients]." Gastroenterologie Clinique Et Biologique, vol. 12, no. 12, 1988, pp. 899-905.
Poynard T, Aubert A, Naveau S, et al. [Sclerotherapy of esophageal varices using ethanol in combination with propranolol: clinical study of 30 patients]. Gastroenterol Clin Biol. 1988;12(12):899-905.
Poynard, T., Aubert, A., Naveau, S., Lemman, M., & Chaput, J. C. (1988). [Sclerotherapy of esophageal varices using ethanol in combination with propranolol: clinical study of 30 patients]. Gastroenterologie Clinique Et Biologique, 12(12), 899-905.
Poynard T, et al. [Sclerotherapy of Esophageal Varices Using Ethanol in Combination With Propranolol: Clinical Study of 30 Patients]. Gastroenterol Clin Biol. 1988;12(12):899-905. PubMed PMID: 3069544.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Sclerotherapy of esophageal varices using ethanol in combination with propranolol: clinical study of 30 patients]. AU - Poynard,T, AU - Aubert,A, AU - Naveau,S, AU - Lemman,M, AU - Chaput,J C, PY - 1988/12/1/pubmed PY - 1988/12/1/medline PY - 1988/12/1/entrez SP - 899 EP - 905 JF - Gastroenterologie clinique et biologique JO - Gastroenterol Clin Biol VL - 12 IS - 12 N2 - A prospective study was conducted in 30 patients to assess the efficacy and safety of endoscopic sclerotherapy with absolute alcohol associated with propranolol for prevention of recurrent variceal bleeding. Patients were included if propranolol alone had failed or if they had at least three factors which increased the risk of rebleeding although the patients were receiving propranolol; two patients were treated by sclerotherapy only because of contraindications to propranolol. Etiology of portal hypertension was cirrhosis in 29 patients and portal vein thrombosis in one patient. Seventeen patients were grade A and 13 were grade B according to Child-Pugh's classification. The cumulative percentage of patients free of rebleeding 12 months after inclusion was 43 +/- 10 p. 100 (m +/- SD). The cause of recurrent bleeding was esophageal varices in nine patients and esophageal ulcers in five patients. The cumulative percentage of variceal rebleeding 12 months after inclusion was 61 +/- 10 p. 100. The cumulative percentages of patients free of rebleeding from varices were not significantly different between the Pugh A (64 +/- 14 p. 100) and Pugh B (56 +/- 15 p. 100) patients. The cumulative percentage of patients surviving 12 months after inclusion was 55 +/- 9 p. 100. The cause of death was not related to sclerotherapy in 11 patients. Two patients died of esophageal wall necrosis associated with mediastinitis. These two patients had received large volumes of sclerosing agent because of important bleeding during the last injection. Our results suggest that in patients without severe cirrhosis who cannot be treated by propranolol alone, the risk of rebleeding and the risk of death are high despite sclerotherapy.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0399-8320 UR - https://www.unboundmedicine.com/medline/citation/3069544/[Sclerotherapy_of_esophageal_varices_using_ethanol_in_combination_with_propranolol:_clinical_study_of_30_patients]_ DB - PRIME DP - Unbound Medicine ER -