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Comparison of endoscopic variceal injection sclerotherapy and ligation for the treatment of esophageal variceal hemorrhage: a prospective randomized trial.
Hepatology. 1995 Jun; 21(6):1517-22.Hep

Abstract

To determine the efficacy of endoscopic variceal sclerotherapy (EVS) and ligation (EVL) in the management of esophageal variceal bleeding, 134 cirrhotic patients were randomized to receive either treatment. The clinical and endoscopic characteristics were similar in both groups. Active bleeding was controlled with ligation (20 of 20) as efficiently as with sclerotherapy (14 of 16). Elective sclerotherapy consumed less time than ligation (7.9 +/- 1.8 minutes vs. 11.5 +/- 2.7 minutes, P < .001), but there was no difference between emergent sclerotherapy (14.5 +/- 5.8 minutes) and ligation (14.9 +/- 4.1 minutes). Ligation reduced one grade of variceal size more quickly than sclerotherapy (1.1 +/- 0.4 vs. 2.0 +/- 1.7 session, P < .001). The rebleeding rate was lower with ligation (13 of 67 vs. 28 of 67, P < .01). Esophageal ulcer was the most common source of rebleeding. Recurrence of varices appears more probable with ligation (P = .079). The complication rate was higher with sclerotherapy (15 of 67 vs. 3 of 67, P < .01), with esophageal stricture being the most common cause. Survival rate was the same in both groups even after stratifying patients into good and poor hepatic reserve groups. Hepatic failure was the major cause of death, followed by exsanguination. In summary, EVL was superior to EVS regarding rebleeding and complications but not in other aspects such as time consumption in elective treatment and recurrence of varices. Substantial results for long-term follow-up are required before conclusion of the treatment of choice.

Authors+Show Affiliations

Department of Medicine, Veterans General Hospital-Taipei, Taiwan, Republic of China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

7768494

Citation

Hou, M C., et al. "Comparison of Endoscopic Variceal Injection Sclerotherapy and Ligation for the Treatment of Esophageal Variceal Hemorrhage: a Prospective Randomized Trial." Hepatology (Baltimore, Md.), vol. 21, no. 6, 1995, pp. 1517-22.
Hou MC, Lin HC, Kuo BI, et al. Comparison of endoscopic variceal injection sclerotherapy and ligation for the treatment of esophageal variceal hemorrhage: a prospective randomized trial. Hepatology. 1995;21(6):1517-22.
Hou, M. C., Lin, H. C., Kuo, B. I., Chen, C. H., Lee, F. Y., & Lee, S. D. (1995). Comparison of endoscopic variceal injection sclerotherapy and ligation for the treatment of esophageal variceal hemorrhage: a prospective randomized trial. Hepatology (Baltimore, Md.), 21(6), 1517-22.
Hou MC, et al. Comparison of Endoscopic Variceal Injection Sclerotherapy and Ligation for the Treatment of Esophageal Variceal Hemorrhage: a Prospective Randomized Trial. Hepatology. 1995;21(6):1517-22. PubMed PMID: 7768494.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of endoscopic variceal injection sclerotherapy and ligation for the treatment of esophageal variceal hemorrhage: a prospective randomized trial. AU - Hou,M C, AU - Lin,H C, AU - Kuo,B I, AU - Chen,C H, AU - Lee,F Y, AU - Lee,S D, PY - 1995/6/1/pubmed PY - 1995/6/1/medline PY - 1995/6/1/entrez SP - 1517 EP - 22 JF - Hepatology (Baltimore, Md.) JO - Hepatology VL - 21 IS - 6 N2 - To determine the efficacy of endoscopic variceal sclerotherapy (EVS) and ligation (EVL) in the management of esophageal variceal bleeding, 134 cirrhotic patients were randomized to receive either treatment. The clinical and endoscopic characteristics were similar in both groups. Active bleeding was controlled with ligation (20 of 20) as efficiently as with sclerotherapy (14 of 16). Elective sclerotherapy consumed less time than ligation (7.9 +/- 1.8 minutes vs. 11.5 +/- 2.7 minutes, P < .001), but there was no difference between emergent sclerotherapy (14.5 +/- 5.8 minutes) and ligation (14.9 +/- 4.1 minutes). Ligation reduced one grade of variceal size more quickly than sclerotherapy (1.1 +/- 0.4 vs. 2.0 +/- 1.7 session, P < .001). The rebleeding rate was lower with ligation (13 of 67 vs. 28 of 67, P < .01). Esophageal ulcer was the most common source of rebleeding. Recurrence of varices appears more probable with ligation (P = .079). The complication rate was higher with sclerotherapy (15 of 67 vs. 3 of 67, P < .01), with esophageal stricture being the most common cause. Survival rate was the same in both groups even after stratifying patients into good and poor hepatic reserve groups. Hepatic failure was the major cause of death, followed by exsanguination. In summary, EVL was superior to EVS regarding rebleeding and complications but not in other aspects such as time consumption in elective treatment and recurrence of varices. Substantial results for long-term follow-up are required before conclusion of the treatment of choice. SN - 0270-9139 UR - https://www.unboundmedicine.com/medline/citation/7768494/Comparison_of_endoscopic_variceal_injection_sclerotherapy_and_ligation_for_the_treatment_of_esophageal_variceal_hemorrhage:_a_prospective_randomized_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0270913995001959 DB - PRIME DP - Unbound Medicine ER -