A Clinical Controlled Trial of Endoscopic Sclerotherapy for Repeated Esophageal Variceal Bleeding

Overview

Journal Gastroenterol Jpn

Specialty Gastroenterology

Date 1989 Feb 1

PMID 2540056

Citations 1

Authors

K L Wu

P D Chou

C M Huang

H S Tang

C F Chen

T C Cheng

Affiliations

Soon will be listed here.

Abstract

Thirty-seven patients with postnecrotic cirrhosis of the liver and 13 patients with primary hepatoma were proven to have repeated bleeding from ruptured esophageal varices. Clinically controlled trials were performed by assigning patients to either sclerotherapy or control arms (25 patients each). Combined intra-variceal and para-variceal injection before an upper endoscopic examination was performed in the sclerotherapy group. In all 25 sclerotherapy cases (100%) hemostasis was successful, which was a statistically significant success rate compared to the control group (52.0%) (p less than 0.01). In the sclerotherapy group 20% (5/25 cases) developed rebleeding, which was less than the 48.0% (7 cases of continuous bleeding and 5 cases of rebleeding) of the control group (p less than 0.05). Four cases (16.0%) in the sclerotherapy group died of erosive gastritis with massive bleeding, compared to 8 fatalities (32.0%) in the control group, because of uncontrolled esophageal variceal bleeding. Endoscopic sclerotherapy is a very effective method for arresting bleeding esophageal varices, and for decreasing the rebleeding rate.

Citing Articles

Long-term study of endoscopic sclerotherapy in Jakarta, Indonesia.

Rani A, Herman H, Manan C, Ali I, Daldiyono Gastroenterol Jpn. 1991; 26 Suppl 3:13-7.

PMID: 1884946 DOI: 10.1007/BF02779254.

References

Bauer J, KREEL I, Kark A . The use of the Sengstaken-Blakemore tube for immediate control of bleeding esophageal varices. Ann Surg. 1974; 179(3):273-7. PMC: 1355886. DOI: 10.1097/00000658-197403000-00005. View

Wirthlin L, LINTON R, ELLIS D . Transthoracoesophageal ligation of bleeding esophageal varices: a reappraisal. Arch Surg. 1974; 109(5):688-92. DOI: 10.1001/archsurg.1974.01360050082018. View

Evans D, Jones D, Cleary B, Smith P . Oesophageal varices treated by sclerotherapy: a histopathological study. Gut. 1982; 23(7):615-20. PMC: 1419768. DOI: 10.1136/gut.23.7.615. View

MacDougall B, Westaby D, Theodossi A, Dawson J, Williams R . Increased long-term survival in variceal haemorrhage using injection sclerotherapy. Results of a controlled trial. Lancet. 1982; 1(8264):124-7. DOI: 10.1016/s0140-6736(82)90378-6. View

Paquet K . Prophylactic endoscopic sclerosing treatment of the esophageal wall in varices -- a prospective controlled randomized trial. Endoscopy. 1982; 14(1):4-5. DOI: 10.1055/s-2007-1021560. View

Cello J, Crass R, Trunkey D . Endoscopic sclerotherapy versus esophageal transection of Child's class C patients with variceal hemorrhage. Comparison with results of portacaval shunt: preliminary report. Surgery. 1982; 91(3):333-8. View

Soehendra N, de Heer K, Kempeneers I, Frommelt L . Morphological alterations of the esophagus after endoscopic sclerotherapy of varices. Endoscopy. 1983; 15(5):291-6. DOI: 10.1055/s-2007-1021537. View

Rose J, Crane M, Smith P . Factors affecting successful endoscopic sclerotherapy for oesophageal varices. Gut. 1983; 24(10):946-9. PMC: 1420152. DOI: 10.1136/gut.24.10.946. View

Carr-Locke D, Sidky K . Broncho-oesophageal fistula: a late complication of endoscopic variceal sclerotherapy. Gut. 1982; 23(11):1005-7. PMC: 1419802. DOI: 10.1136/gut.23.11.1005. View

10.

Koch H, Henning H, Grimm H, Soehendra N . Prophylactic sclerosing of esophageal varices--results of a prospective controlled study. Endoscopy. 1986; 18(2):40-3. DOI: 10.1055/s-2007-1018322. View

11.

Snady H, Korsten M, Waye J . The relationship of bacteremia to the length of injection needle in endoscopic variceal sclerotherapy. Gastrointest Endosc. 1985; 31(4):243-6. DOI: 10.1016/s0016-5107(85)72172-4. View

12.

Waldram R, Davis M, Nunnerley H, Williams R . Emergency endoscopy after gastrointestinal haemorrhage in 50 patients with portal hypertension. Br Med J. 1974; 4(5936):94-6. PMC: 1612155. DOI: 10.1136/bmj.4.5936.94. View

13.

Novis B, Duys P, Barbezat G, Clain J, Bank S, Terblanche J . Fibreoptic endoscopy and the use of the Sengstaken tube in acute gastrointestinal haemorrhage in patients with portal hypertension and varices. Gut. 1976; 17(4):258-63. PMC: 1411108. DOI: 10.1136/gut.17.4.258. View

14.

Jorge A . Injection sclerotherapy of esophageal varices. Endoscopy. 1982; 14(4):115-8. DOI: 10.1055/s-2007-1021596. View

15.

Johnson W, Widrich W, Ansell J, Robbins A, Nabseth D . Control of bleeding varices by vasopressin: a prospective randomized study. Ann Surg. 1977; 186(3):369-76. PMC: 1396353. DOI: 10.1097/00000658-197709000-00015. View

16.

Jorge A, Adami J, Seiffert L, Segal E . Sclerotherapy of esophageal varices--Argentinian experience. Endoscopy. 1983; 15 Suppl 1:141-3. DOI: 10.1055/s-2007-1021489. View

17.

Teres J, Cecilia A, Bordas J, Rimola A, Bru C, Rodes J . Esophageal tamponade for bleeding varices. Controlled trial between the Sengstaken-Blakemore tube and the Linton-Nachlas tube. Gastroenterology. 1978; 75(4):566-9. View

18.

Sarin S, Nanda R, Vij J, Anand B . Oesophageal ulceration after sclerotherapy--a complication or an accompaniment?. Endoscopy. 1986; 18(2):44-5. DOI: 10.1055/s-2007-1018323. View

19.

Soehendra N, de Heer K, Kempeneers I, Runge M . Sclerotherapy of esophageal varices: acute arrest of gastrointestinal hemorrhage or long-term therapy?. Endoscopy. 1983; 15 Suppl 1:136-40. DOI: 10.1055/s-2007-1021488. View

20.

HEDBERG S, Fowler D, RYAN R . Injection sclerotherapy of esophageal varices using ethanolamine oleate. Am J Surg. 1982; 143(4):426-31. DOI: 10.1016/0002-9610(82)90191-x. View