Efficacy of five days of subcutaneous octreotide treatment after sclerotherapy in preventing rebleeding from esophageal varices.
OBJECTIVE
Acute variceal bleeding is the most severe consequence of portal hypertension. Mortality due to bleeding among cirrhotic patients is high; between 30 and 50% die within six weeks of the first bleeding episode. This dismal outcome has led to attempts both to stop acute bleeding and to prevent rebleeding. The aim of this study was to investigate the efficacy of subcutaneous octreotide treatment, administered after emergency sclerotherapy, in preventing rebleeding of esophageal varices


METHODS
After a bolus injection of 50 microgram octreotide, 34 patients, forming the standard therapy (ST) group, received octreotide infusion at a rate of 50 microgram/h until endoscopic sclerotherapy performed within 36 hours. The same procedure was applied to another 27 patients in the maintenance therapy (MT) group in which octreotide was given at 100 microgram/8h via subcutaneous (sc) route after sclerotherapy for five days. In both groups, sclerotherapy was repeated on the 5th-7th day. Patients were followed for three weeks for rebleeding.


RESULTS
Nine patients rebled in the ST group but only one patient bled in the MT group (3.7% vs. 26.5% vs. 3.7%; p<0.05). Transfusion requirement and duration of hospitalization period were similar in both groups.


CONCLUSIONS
This study suggests that maintenance subcutaneous octreotide therapy is effective in controlling rebleeding episodes.
Yücesoy
Mehmet
M
Department of Gastroenterology, School of Medicine, Erciyes University, Kayseri, Turkey.
Başkol
Mevlüt
M
Keklik
Muzaffer
M
Güven
Muhammed
M
Sungur
Murat
M
Gürsoy
Sebnem
S
Güven
Kadri
K
Ozbakir
Omer
O
D000208:Acute Disease; D016099:Endoscopy, Gastrointestinal; D004932:Esophageal and Gastric Varices / Q000517:prevention & control* / Q000628:therapy; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006471:Gastrointestinal Hemorrhage / Q000517:prevention & control*; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000379:methods; D055502:Secondary Prevention; D013997:Time Factors; D016896:Treatment Outcome
D005765:Gastrointestinal Agents; D015282:Octreotide