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A prospective, randomized trial of sclerotherapy versus ligation in the management of bleeding esophageal varices.
Hepatology. 1995 Aug; 22(2):466-71.Hep

Abstract

We conducted a prospective, randomized trial comparing sclerotherapy and ligation in 120 patients with acute bleeding of esophageal varices. All the patients were cirrhotic, 59 received sclerotherapy, and 61 received ligation. Treatment was repeated regularly until the varices were obliterated. The mean follow-up period was 295 +/- 120 days and 310 +/- 105 days for the sclerotherapy and ligation groups, respectively. The control of active bleeding was 12/15 (80%) in the sclerotherapy group and 18/19 (94%) in the ligation group (P = .23). The numbers of treatment sessions required to achieve variceal obliteration were 6.5 +/- 1.2 in the sclerotherapy group and 3.8 +/- 0.4 in the ligation group (P < .001). Recurrent bleeding from the gastrointestinal tract was 51% in the sclerotherapy group compared with 33% in the ligation group (P < .05). Recurrent bleeding from esophageal varices was 36% in the sclerotherapy group and 11% in the ligation group (P < .01). However, bleeding from ectopic varices and congestive gastropathy was less common in the sclerotherapy group (7%) than in the ligation group (18%) (P = .05). Significant complications were encountered in 19% of the sclerotherapy group and in 3.3% of the ligation group (P < .01). Comparison of Kaplan-Meier estimates of time to death of both groups showed a significantly lower mortality in the ligation group (P = .011). Both sclerotherapy and ligation can effectively arrest active bleeding from esophageal varices. However, ligation is more effective than sclerotherapy in decreasing the risk of rebleeding from esophageal varices with fewer complications. Ligation can also achieve obliteration of esophageal varices more rapidly than sclerotherapy.(

ABSTRACT

TRUNCATED AT 250 WORDS)

Authors+Show Affiliations

Department of Medicine, Veterans General Hospital-Kaohsiung, National Yang-Ming University, Taipei, Taiwan, Republic of China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

7635414

Citation

Lo, G H., et al. "A Prospective, Randomized Trial of Sclerotherapy Versus Ligation in the Management of Bleeding Esophageal Varices." Hepatology (Baltimore, Md.), vol. 22, no. 2, 1995, pp. 466-71.
Lo GH, Lai KH, Cheng JS, et al. A prospective, randomized trial of sclerotherapy versus ligation in the management of bleeding esophageal varices. Hepatology. 1995;22(2):466-71.
Lo, G. H., Lai, K. H., Cheng, J. S., Hwu, J. H., Chang, C. F., Chen, S. M., & Chiang, H. T. (1995). A prospective, randomized trial of sclerotherapy versus ligation in the management of bleeding esophageal varices. Hepatology (Baltimore, Md.), 22(2), 466-71.
Lo GH, et al. A Prospective, Randomized Trial of Sclerotherapy Versus Ligation in the Management of Bleeding Esophageal Varices. Hepatology. 1995;22(2):466-71. PubMed PMID: 7635414.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective, randomized trial of sclerotherapy versus ligation in the management of bleeding esophageal varices. AU - Lo,G H, AU - Lai,K H, AU - Cheng,J S, AU - Hwu,J H, AU - Chang,C F, AU - Chen,S M, AU - Chiang,H T, PY - 1995/8/1/pubmed PY - 1995/8/1/medline PY - 1995/8/1/entrez SP - 466 EP - 71 JF - Hepatology (Baltimore, Md.) JO - Hepatology VL - 22 IS - 2 N2 - We conducted a prospective, randomized trial comparing sclerotherapy and ligation in 120 patients with acute bleeding of esophageal varices. All the patients were cirrhotic, 59 received sclerotherapy, and 61 received ligation. Treatment was repeated regularly until the varices were obliterated. The mean follow-up period was 295 +/- 120 days and 310 +/- 105 days for the sclerotherapy and ligation groups, respectively. The control of active bleeding was 12/15 (80%) in the sclerotherapy group and 18/19 (94%) in the ligation group (P = .23). The numbers of treatment sessions required to achieve variceal obliteration were 6.5 +/- 1.2 in the sclerotherapy group and 3.8 +/- 0.4 in the ligation group (P < .001). Recurrent bleeding from the gastrointestinal tract was 51% in the sclerotherapy group compared with 33% in the ligation group (P < .05). Recurrent bleeding from esophageal varices was 36% in the sclerotherapy group and 11% in the ligation group (P < .01). However, bleeding from ectopic varices and congestive gastropathy was less common in the sclerotherapy group (7%) than in the ligation group (18%) (P = .05). Significant complications were encountered in 19% of the sclerotherapy group and in 3.3% of the ligation group (P < .01). Comparison of Kaplan-Meier estimates of time to death of both groups showed a significantly lower mortality in the ligation group (P = .011). Both sclerotherapy and ligation can effectively arrest active bleeding from esophageal varices. However, ligation is more effective than sclerotherapy in decreasing the risk of rebleeding from esophageal varices with fewer complications. Ligation can also achieve obliteration of esophageal varices more rapidly than sclerotherapy.(ABSTRACT TRUNCATED AT 250 WORDS) SN - 0270-9139 UR - https://www.unboundmedicine.com/medline/citation/7635414/A_prospective_randomized_trial_of_sclerotherapy_versus_ligation_in_the_management_of_bleeding_esophageal_varices_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0270913995002795 DB - PRIME DP - Unbound Medicine ER -