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Abstract
Summary and Conclusion<br The management of patients with variceal haemorrhage has changed quite markedly in recent years. While endoscopic sclerotherapy has been used successfully in the management of oesophageal varices for more than two decades, more recently variceal band ligation has lessened the morbidity and associated with endoscopic therapy.
Combined sclerotherapy and ligation has emerged recently to combine the advantages of both techniques. However, the published results of this combination therapy have been conflicting.
This work was conducted to assess the clinical and endoscopic outcome of different endoscopic treatment modalities.
In this study, 64 patients with bleeding oesophageal varices were randomly allocated into three groups; group I(21 patients), group II (22 patients), and group III (21 patients). These groups were scheduled to sclerotherapy, band ligation and combined band ligation and sclerotherapy respectively.
All patients were subjected to clinical assessment, laboratory investigations, abdominal ultrasonography and upper endoscopy. Patients were followed up to 6 months.
Active bleeding was controlled in 95% of patients in group I and III and in 100% of patients in group II. No significant difference was found in re-bleeding, systemic or local complications between all groups. In group III, sessions required to obliterate varices were significantly lower than group I (3.2±1.5 Vs 4.4±1.3) (p<0.05).
In addition, the amount of sclerosants used in group III was significantly less than group I (10.1±4.3 Vs 49.7±18.2) (p<0.001). Variceal recurrence occurred after 6 months in 10%, 15% and 5% of patients in group I, II and III respectively. Although recurrence was highest in group II, the difference was insignificant.