ENDOSCOPIC SCLEROTHERAPY VERSUS ESOPHAGEAL TRANSECTION IN THE PREVENTION OF VARICEAL REBLEEDING

Objective: To compare sclerotherapy with oesophageal transection in th e prevention of rebleeding in patients with oesophageal varices. Desig n: A prospective trial. Patients: Forty-one patients with cirrhosis an d variceal bleeding. Methods: After recovering from an acute episode o f oesophageal variceal bleeding patients were randomized into two grou ps. One patient was excluded. Twenty-two patients were treated with sc lerotherapy (group 1) and 18 underwent an oesophageal transection (gro up 2), with a shorter elapsed time from randomization to treatment in group 1. Both groups were similar with regard to clinical and biochemi cal features and variceal size. Failure, defined in group 1 as rebleed ing or incomplete eradication after four sclerotherapy sessions, occur red in five (22.7%) patients; in group 2, rebleeding occurred in two ( 11.1%) patients (no statistically significant difference). Conclusion: Although the survival rate was similar in both groups, sclerotherapy is preferable to oesophageal transection because it requires a shorter duration of hospitalization and has fewer complications.