Frequent endoscopic variceal sclerotherapy increases risk of complications - Prospective randomized controlled study of two treatment schedules

Evangelos Akriviadis, Jacob Korula, Sanjeev Gupta, Young Ko, Suyenori Yamada

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

In an effort to determine the optimal dose and frequency of chronic endoscopic variceal sclerotherapy, a prospective randomized controlled study comparing two treatment schedules of sclerotherapy was carried out over a 21-month period. Patients with variceal hemorrhage were randomly assigned to receive sclerotherapy at weekly intervals using injection volumes of >15 cc at each treatment or at mean intervals of three days using volumes of <10 cc per treatment. Esophageal perforation occurred in three patients (15%) in the small-dose, frequent-injection group as compared to none in the large-dose weekly treatment group (P=0.07), leading to premature termination of the study. The mean time to rebleeding was significantly shorter in the small-dose, frequent-treatment group (P=0.05). Variceal obliteration was achieved in a mean of 66% of patients in both groups with no difference in the time to obliteration or the frequency of other complications. Sclerotherapy offered at less than weekly intervals is less effective and is associated with an increased frequency of serious and life threatening complications.

Original languageEnglish (US)
Pages (from-to)1068-1074
Number of pages7
JournalDigestive Diseases and Sciences
Volume34
Issue number7
DOIs
Publication statusPublished - Jul 1 1989
Externally publishedYes

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Keywords

  • sclerotherapy
  • two treatment schedules

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

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