[Octreotide administration and/or endoscopic treatment in cirrhotic patients with acute variceal bleeding: a multicentric study].
BACKGROUND
Acute variceal bleeding in cirrhotic patients is an emergency with a high risk of rebleeding and death. Endoscopic procedures such as sclerotherapy or banding, combined or not with drugs such as octreotide could be considered.


OBJECTIVE
To assess the value of octreotide in the control of acute variceal bleeding.


METHODS
Ninety-two patients were randomized into three groups: endoscopic therapy plus octreotide 50 microg/h bolus and continuous infusion for 5 days (n=36); octreotide (same dosage) (n=13) and endoscopic therapy only (banding and/or sclerotherapy) (n=43).


RESULTS
Haemostasis at 24 hours was achieved in 97% of patients with combined treatment, 69% of patients receiving octreotide, and 93% of patients with endoscopic therapy (p=0.2). Three patients with combined treatment, four patients receiving octreotide and eight patients with endoscopic therapy, rebled during the first five days (p=0.15). The mean of blood units transfused was similar in the three groups. No differences were observed in hospital days and side effects. At 42 days of follow up, eight patients with endoscopic therapy, one patients with combined therapy and 2 patients receiving octreotide, died (p=NS).


CONCLUSIONS
Octreotide is useful in the management of acute variceal bleeding. The absence of important side effects, renders it as a safe adjuvant treatment associated with endoscopic treatment.
Silva
Guillermo
G
Departamento de Gastroenterología, Clínica Las Condes. GuillermoSilvap@entelchile.net
Quera
Rodrigo
R
Fluxá
Fernando
F
Sanhueza
Edgar
E
Segovia
Roberto
R
Brahm
Javier
J
Muñoz
Cristián
C
Morales
Antonio
A
Muñoz
Lorena
L
Urzúa
Luis
L
Biagini
Leandro
L
D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000628:therapy*; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008026:Ligation; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D011446:Prospective Studies; D015911:Sclerotherapy
D005765:Gastrointestinal Agents; D015282:Octreotide
Octreótido, tratamiento endoscópico o ambos en la hemorragia variceal activa en pacientes cirróticos: estudio multicéntrico.