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Endoscopic variceal ligation versus endoscopic variceal ligation and endoscopic sclerotherapy: a prospective randomized study.
Am J Gastroenterol. 1997 Jun; 92(6):950-3.AJ

Abstract

OBJECTIVE

To compare endoscopic variceal ligation (EVL) with a combination of EVL and endoscopic scelerotherapy (EST) in the secondary prophylaxis of esophageal variceal bleeding.

METHODS

Fifty patients with esophageal varices due to cirrhosis of the liver (38), noncirrhotic portal fibrosis (7), or extrahepatic portal venous obstruction (5) were included in the study. These 50 patients were randomized to receive either EVL alone or a combination of EVL and EST for variceal eradication. Twenty-one patients received EVL alone (group A), and 23 patients received EVL and EST (group B). In group B, EVLs were performed until the varices were reduced to grade II size, and, subsequently, these patients underwent low-dose sclerotherapy with 1% polidocanol until variceal eradication was achieved.

RESULTS

Combined EVL and EST treatment eradicated the varices in a significantly greater number of patients then EVL alone (87% vs. 24%; p < 0.05). However, significantly more endoscopic sessions were required with combined treatment than with EVL alone (5.87 +/- 2.32 vs. 4.28 +/- 1.82; p < 0.05). Rebleeding episodes before variceal eradication were similar in the two groups (19% vs. 22%). The complications were similar in both the EVL and the EVL-plus-EST group, ie., deep ulcers (16% vs. 20%), transient dysphagia (20% vs. 32%), and stricture (4% vs. 8%).

CONCLUSION

Thus, combined EVL and EST treatment eradicates varices in a significantly larger number of patients than EVL alone, with no extra complications.

Authors+Show Affiliations

Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi.No affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

9177508

Citation

Bhargava, D K., and R Pokharna. "Endoscopic Variceal Ligation Versus Endoscopic Variceal Ligation and Endoscopic Sclerotherapy: a Prospective Randomized Study." The American Journal of Gastroenterology, vol. 92, no. 6, 1997, pp. 950-3.
Bhargava DK, Pokharna R. Endoscopic variceal ligation versus endoscopic variceal ligation and endoscopic sclerotherapy: a prospective randomized study. Am J Gastroenterol. 1997;92(6):950-3.
Bhargava, D. K., & Pokharna, R. (1997). Endoscopic variceal ligation versus endoscopic variceal ligation and endoscopic sclerotherapy: a prospective randomized study. The American Journal of Gastroenterology, 92(6), 950-3.
Bhargava DK, Pokharna R. Endoscopic Variceal Ligation Versus Endoscopic Variceal Ligation and Endoscopic Sclerotherapy: a Prospective Randomized Study. Am J Gastroenterol. 1997;92(6):950-3. PubMed PMID: 9177508.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic variceal ligation versus endoscopic variceal ligation and endoscopic sclerotherapy: a prospective randomized study. AU - Bhargava,D K, AU - Pokharna,R, PY - 1997/6/1/pubmed PY - 1997/6/1/medline PY - 1997/6/1/entrez SP - 950 EP - 3 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 92 IS - 6 N2 - OBJECTIVE: To compare endoscopic variceal ligation (EVL) with a combination of EVL and endoscopic scelerotherapy (EST) in the secondary prophylaxis of esophageal variceal bleeding. METHODS: Fifty patients with esophageal varices due to cirrhosis of the liver (38), noncirrhotic portal fibrosis (7), or extrahepatic portal venous obstruction (5) were included in the study. These 50 patients were randomized to receive either EVL alone or a combination of EVL and EST for variceal eradication. Twenty-one patients received EVL alone (group A), and 23 patients received EVL and EST (group B). In group B, EVLs were performed until the varices were reduced to grade II size, and, subsequently, these patients underwent low-dose sclerotherapy with 1% polidocanol until variceal eradication was achieved. RESULTS: Combined EVL and EST treatment eradicated the varices in a significantly greater number of patients then EVL alone (87% vs. 24%; p < 0.05). However, significantly more endoscopic sessions were required with combined treatment than with EVL alone (5.87 +/- 2.32 vs. 4.28 +/- 1.82; p < 0.05). Rebleeding episodes before variceal eradication were similar in the two groups (19% vs. 22%). The complications were similar in both the EVL and the EVL-plus-EST group, ie., deep ulcers (16% vs. 20%), transient dysphagia (20% vs. 32%), and stricture (4% vs. 8%). CONCLUSION: Thus, combined EVL and EST treatment eradicates varices in a significantly larger number of patients than EVL alone, with no extra complications. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/9177508/Endoscopic_variceal_ligation_versus_endoscopic_variceal_ligation_and_endoscopic_sclerotherapy:_a_prospective_randomized_study_ L2 - https://antibodies.cancer.gov/detail/CPTC-SULT1E1-1 DB - PRIME DP - Unbound Medicine ER -