ESOPHAGEAL VARICES

A comparative trial was conducted to study the relative efficacy ofendoscopic injection sclerotherapy versus endoscopic injection sclerotherapy plus octreotide with reference to acutecontrol of bleeding esophageal varices and early re-bleeding. A total of 58 patients equally divided in two groups wereincluded in this study. Bleeding was controlled in 90% patients in both the groups. In group1 there were 20(68.96%)males and18(62%) males in group 2. The mean age of the patients under study was 50.62 &50.55 in group 1& 2respectively. The major proportion of patients was in Child Class B, which comprised of 42(72.41%) in total. ChildClass C was excluded out of study. Twenty-two (75.86%) patients in group 1 were in Child Class B and 7(24%) werein Child Class A & in group 2 there were 20 (68.96%) patients in Child Class B and 21% were in Class A. Etiology ofcirrhosis was HCV in 41(70.86%) and HBV in 9(15.5%) and other etiologies in remaining patients. In, group 1,HCVrelated cirrhosis was seen in 20 (68.96%) and in group 2, this was responsible for cirrhosis in 21(70.68%) of patients.Patients suffering from HBV related cirrhosis were 5(17.42%) in first group and 4(13.79%) in second group 2. Relativelyless number of patients in group 2, had rebleeding in first week of their in-hospital follow-up i.e. 5 versus 8 patients.Average number of blood transfusions per patient was 3.86 piants in group 1and 2.45 piants in group 2. The meanduration of Hospital stay was 8.52 days in group 1 and 7.45 days in group 2. Procedure related complications and inhospital outcome was almost comparable in two groups. The most common complication was hepatic encephalopathy.Combining endoscopic therapy with one of the vasoactive agents reduces the chances of early re-bleeding and needfor number of blood transfusions and duration of hospital stay.