ENDOSCOPIC SCLEROTHERAPY VERSUS ESOPHAGEAL TRANSECTION IN THE PREVENTION OF VARICEAL REBLEEDING

Objective: To compare sclerotherapy with oesophageal transection in the prevention of rebleeding in patients with oesophageal varices. Design: A prospective trial. Patients: Forty-one patients with cirrhosis and variceal bleeding. Methods: After recovering from an acute episode of oesophageal variceal bleeding patients were randomized into two groups. One patient was excluded. Twenty-two patients were treated with sclerotherapy (group 1) and 18 underwent an oesophageal transection (group 2), with a shorter elapsed time from randomization to treatment in group 1. Both groups were similar with regard to clinical and biochemical features and variceal size. Failure, defined in group 1 as rebleeding or incomplete eradication after four sclerotherapy sessions, occurred 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.