Variceal band ligation and variceal band ligation plus sclerotherapy in the prevention of recurrent variceal bleeding in cirrhotic patients: a randomized, prospective and controlled trial

Background: The combination treatment of band ligation plus sclerotherapy h as been proposed to hasten variceal eradication. The aim of this study was to assess the efficacy of band ligation alone versus band ligation plus scl erotherapy in the prevention of recurrent variceal bleeding, Methods: Eighty cirrhotic patients were randomized to group I (band ligatio n) with 41 patients or to group II (band ligation plus sclerotherapy) with 39 patients in whom polidocanol (2%) was injected 1 to 2 cm proximal to eac h band. Results: At baseline, both groups were similar with regard to clinical, dem ographic and laboratory data. Mean follow-up time (standard error) for grou p I was 336.5 +/- 43.4 days and for group II 386.1 +/- 40.1 days (p = 0.4), No statistical differences were observed between group I and group II in r elation to recurrence of bleeding (31.7% vs. 23%, p = 0.38), treatment fail ure (24.4% vs, 12.8%, p = 0.18), death (39% vs. 30.8%, p = 0.44) and varice al eradication (65.8% vs. 74.4%, p = 0.40), Group II had a significantly hi gher number of complications than group 1, 30.8% versus 7.3%, respectively (p = 0.05). The number of bleeding related deaths was higher in group I tha n in group 11 (22% vs. 10.3%, respectively; p = 0.15). Conclusions: No significant difference was observed between band ligation a nd band ligation plus sclerotherapy in prevention of recurrent variceal ble eding. Furthermore, there was a higher incidence of complications in the la tter group.