Does therapy of oesophageal varices influences the progression of varices?
BACKGROUND
Aim of this study was to determine the progression time of oesophageal varices in patients with cirrhosis and to study whether therapy of varices has an impact on the progression time. Parameters associated with the progression of oesophageal varices were analyzed as well.


METHODS
One hundred and eighty-one cirrhotic patients (Child A/B/C: 105/69/15; Child score 7.6+/-2.0, initial variceal grade 1.7+/-0.9) undergoing repeated endoscopy for follow-up and/or treatment of oesophageal varices were retrospectively analyzed. A multivariate logistic regression analysis was applied to identify independent determinants of progression of oesophageal varices.


RESULTS
Of the 189 patients, 26 patients were on beta-blocker therapy only, 52 patients underwent ligation therapy only, and 37 patients received a combination of ligation and beta-blocker therapy of varices. The mean time of progression of oesophageal varices by one grade was 384+/-364 days. This interval did not vary significantly between patients who underwent no treatment or were on a beta-blocker and/or ligation therapy. The serum bilirubin (hazard ratio 1.030; 95% confidence interval, 1.004, 1.055; P<0.03) was the only parameter independently associated with the progression of varices. Initial eradication of varices was achieved after 2.2+/-1.5 ligation sessions. Rings of 6.1+/-2.5 were used in the first banding session and 11.5+/-8.9 rings were needed to achieve eradication of varices.


CONCLUSIONS
Therapy of oesophageal varices does not influence the progression time of oesophageal varices in patients with cirrhosis of the liver.
Biecker
Erwin
E
Department of Internal Medicine I, University Hospital of Bonn, Bonn, Germany. erwin.biecker@helios-kliniken.de
Classen
Leonie
L
Sauerbruch
Tilman
T
Schepke
Michael
M
D016001:Confidence Intervals; D018450:Disease Progression; D004932:Esophageal and Gastric Varices / Q000473:pathology* / Q000601:surgery; D004945:Esophagoscopy; D005260:Female; D006801:Humans; D008026:Ligation; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors