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Endoscopic sclerotherapy versus oral propranolol after variceal hemorrhage in cirrhosis results of a 4 year prospective randomized trial



Endoscopic sclerotherapy versus oral propranolol after variceal hemorrhage in cirrhosis results of a 4 year prospective randomized trial



Gastroenterologie Clinique et Biologique 12(3): 234-239



Between December 1982 and April 1987, we conducted a prospective randomized trial comparing the efficiency of endoscopic sclerotherapy with oral propranolol after variceal hemorrhage in cirrhosis. We present our results after a median follow-up of 3 years (range = 57-231 weeks). The sclerotherapy group (S) consisted of 28 patients and the propranolol gorup (P), 27 patients. The two groups were similar for age, sex, etiology and severity of liver disease, and severity of hemorrhage; the only difference concerned previous hemorrhages which were significantly more numerous in the S group. Sclerotherapy was performed with polidocanol 1 p. 100. A slow-release preparation of propranolol was used; the average daily dose was 160 mg. Eighteen patients in the S group had at least one hemorrhagic recurrence was apposed to 12 in the P group. This difference was not significant nor was the difference between actuarial curves of no-rebleeding (p = 0.30). No difference was noted concerning total deaths (15 in S versus 12 in P). Cumulative survival curves showed a non-significative difference (p = 0.99) percentages of survival in S and P groups were 75.0 p. 100 and 73.6 p. 100 at 1 year, 67.9 p. 100 and 64.6 p. 100 at 2 years, and 51.1 p. 100 and 52.7 p. 100 at 3 years respectively. Stratification according to Child's group, variceal size and history of variceal hemorrhage did not modify these results. However, male patients had less hemorrhagic recurrences with propranolol than after sclerotherapy. Length of hospitalization was not different in the two groups. Our conclusion is that no significant difference in efficiency of sclerotherapy and oral propranolol in cirrhosis was found. However, our population was very severely selected and was probably not large enough.

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