DOES PROPRANOLOL MAINTAIN POST-SCLEROTHERAPY VARICEAL OBLITERATION - A PROSPECTIVE RANDOMIZED STUDY

Variceal recurrence and rebleeding are common after initial obliterati on by injection sclerotherapy. To investigate whether propranolol can maintain variceal obliteration by sclerotherapy, 59 patients with oeso phageal variceal bleeding after sclerotherapy were enrolled. Patients were allocated to propranolol treatment (30 patients) or served as con trols (29 patients). After a mean follow up of 2 years and 4 months, 5 3 patients completed the study. Fifty-eight per cent of the propranolo l group versus 77% of the control group experienced recurrent varices (P = 0.20). Fifteen per cent of the propranolol group versus 11% of th e control group developed cardiac varices. Recurrent variceal bleeding was encountered in 27% of the propranolol group and 19% of the contro l group. Three patients in the propranolol group, compared with two pa tients in the control group, died of massive variceal bleeding. Eighty per cent of them bled from cardiac varices. Both groups had similar s urvival rates. We therefore concluded that the use of propranolol afte r variceal obliteration by sclerotherapy can neither prevent oesophago gastric variceal recurrence nor prevent further rebleeding.