A TRIAL OF ELECTIVE VERSUS ON DEMAND SCLEROTHERAPY IN POOR-RISK PATIENTS WITH VARICEAL HEMORRHAGE

A prospective randomised trial of ''planned'' chronic injection sclero therapy (at three weekly intervals) versus ''demand'' injection sclero therapy (after variceal bleeds only) was performed in 40 patients who had endoscopically proven variceal bleeding, and who were either grade d as modified Child's grade C or were more than 65 years of age. 45% o f patients survived for one year and 37% for two years. There was no s ignificant difference in survival between the groups at either one or two years (p <0.5; p <0.1). In the ''planned'' sclerotherapy group 24 gastrointestinal bleeds occurred in 11 patients over the first nine mo nths after study entry. In the ''demand'' group 35 bleeds occurred in 13 patients over the first 18 months after study entry. In this small group of ''poor risk'' patients, planned chronic injection sclerothera py was not associated with improved survival.