Sclerotherapy versus sclerotherapy and propranolol in the prevention of rebleeding from oesophageal varices: a randomised study.
BACKGROUND
This trial was carried out to assess the value of propranolol in the prevention of recurrent variceal bleeding when combined with longterm endoscopic sclerotherapy.


METHODS
Two hundred patients (161 male, 39 female, age range 20-68 years) with portal hypertension resulting mainly from schistosomal periportal fibrosis or posthepatitic cirrhosis presenting with their first episode of haematemesis or melena, or both were included. This was confirmed endoscopically to result from ruptured oesophageal varices. After initial control of bleeding, patients were randomised into two groups: group 1 treated with endoscopic sclerotherapy alone and group 2 treated with sclerotherapy plus propranolol. They were followed up for two years.


RESULTS
Group (2) had a lower rebleeding rate (14.3% v 38.6% in group 1), lower variceal recurrence after obliteration (17% v 34% in group 1), longer period between variceal obliteration and recurrence (36 weeks v 21 weeks in group 1); but no change in mortality (12% in both groups).


CONCLUSIONS
Patients treated with sclerotherapy should be given propranolol for longterm management.
Elsayed
S S
SS
Department of Internal Medicine, Al-Mansoura Faculty of Medicine, Egypt.
Shiha
G
G
Hamid
M
M
Farag
F M
FM
Azzam
F
F
Awad
M
M
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011433:Propranolol / Q000627:therapeutic use*; D012008:Recurrence; D015911:Sclerotherapy
D000959:Antihypertensive Agents; D011433:Propranolol