Endoscopic Variceal Ligation plus Octreotide versus Variceal Ligation Alone for the Prevention of Early Rebleeding from Esophageal Varices

Korean J Hepatol > Volume 5(4); 1999 > Article

The Korean Journal of Hepatology 1999;5(4): 299-305.

식도정맥류의 조기 재출혈 예방에 결찰요법과 Octreotide의 병용치료와 결찰요법 단독치료의 효과비교 ( Endoscopic Variceal Ligation plus Octreotide versus Variceal Ligation Alone for the Prevention of Early Rebleeding from Esophageal Varices )

Endoscopic Variceal Ligation plus Octreotide versus Variceal Ligation Alone for the Prevention of Early Rebleeding from Esophageal Varices

Gyu Hyun Lee, M.D., Sung Won Cho, M.D., Heon Jong Kim, M.D. Kwang Hyun Ko, M.D., Young Yun Ko, M.D., Jun Ho Ko, M.D. Ho Dong Kim, M.D., Kwang Jae Lee, M.D., Ki Baik Hahm, M.D. and Jin Hong Kim, M.D.

Department of Gastroenterology, Ajou University College of Medicine, Suwon, Korea

ABSTRACT

Background/Aims
Endoscopic variceal ligation (EVL) has been effective modality for esophageal variceal bleeding, but recurrent bleeding occurs 20 to 40% of patients. So there has been an increased interest in the use of vasoactive drugs to lower portal hypertension and help control variceal bleeding before and after endoscopy. We investigated the efficacy of octreotide (OCT) infusion as an adjunct to EVL for preventing early rebleeding from varices. Methods: From Jan. 1997 to Feb. 1999, fifty four patients with endoscopically documented esophageal variceal bleeding were included. The patients were randomly treated by EVL alone (EVL group, n=30) or EVL plus octreotide (EVL+OCT group, n=24). We evaluated the 5-day and 6-week rebleeding rate and 6-week mortality. Results: Baseline characteristics were similar in two group but hospital stay (p=0.028) and units of transfused blood (p=0.043) were significantly less in EVL+OCT group. There were no significant differences on 5-day rebleeding rate (EVL group; 7%, EVL+OCT group; 0%) and 6-week rebleeding rate (EVL group; 20%, EVL+OCT group; 4%). Conclusions: The combined therapy did not decrease early rebleeding and mortality, but it was superior to EVL alone in hospital course such as requirement of transfusion and duration of hospitalization. (Korean J Hepatol 1999;5:299－305)

KeyWords: Esophageal variceal bleeding, Endoscopic variceal ligation, Octreotide