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

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

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-ay and 6-eek rebleeding rate and 6-eek 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-ay rebleeding rate (EVL group; 7%, EVL+OCT group; 0%) and 6-eek 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.