title: Comparison between endoscopic sclerotherapy and band ligation for hemostasis of acute variceal bleeding.
abstract: OBJECTIVE
  To compare band ligation (BL) with endoscopic sclerotherapy (SCL) in patients admitted to an emergency unit for esophageal variceal rupture.
  
  
  METHODS
  A prospective, randomized, single-center study without crossover was conducted. After endoscopic diagnosis of esophageal variceal rupture, patients were randomized into groups for SCL or BL treatment. Sclerotherapy was performed by ethanolamine oleate intravascular injection both above and below the rupture point, with a maximum volume of 20 mL. For BL patients, banding at the rupture point was attempted, followed by ligation of all variceal tissue of the distal esophagus. Primary outcomes for both groups were initial failure of bleeding control (5 d), early re-bleeding (5 d to 6 wk), and complications, including mortality. From May 2005 to May 2007, 100 patients with variceal bleeding were enrolled in the study: 50 SCL and 50 BL patients. No differences between groups were observed across gender, age, Child-Pugh status, presence of shock at admission, mean hemoglobin levels, and variceal size.
  
  
  RESULTS
  No differences were found between groups for bleeding control, early re-bleeding rates, complications, or mortality. After 6 wk, 36 (80%) SCL and 33 (77%) EBL patients were alive and free of bleeding. A statistically significant association between Child-Pugh status and mortality was found, with 16% mortality in Child A and B patients and 84% mortality in Child C patients (P<0.001).
  
  
  CONCLUSIONS
  Despite the limited number of patients included, our results suggest that SCL and BL are equally efficient for the control of acute variceal bleeding.
authors.affiliation: Gustavo Oliveira Luz, Fauze Maluf-Filho, Sérgio Eiji Matuguma, Fábio Yuji Hondo, Edson Ide, Jeane Martins Melo, Spencer Cheng, Paulo Sakai, Gastrointestinal Endoscopy Unit, Hospital das Clínicas, São Paulo University Medical School, São Paulo 05612000, Brazil.
authors.forename: Gustavo Oliveira
authors.initials: GO
authors.lastname: Luz
authors.forename: Fauze
authors.initials: F
authors.lastname: Maluf-Filho
authors.forename: Sérgio Eiji
authors.initials: SE
authors.lastname: Matuguma
authors.forename: Fábio Yuji
authors.initials: FY
authors.lastname: Hondo
authors.forename: Edson
authors.initials: E
authors.lastname: Ide
authors.forename: Jeane Martins
authors.initials: JM
authors.lastname: Melo
authors.forename: Spencer
authors.initials: S
authors.lastname: Cheng
authors.forename: Paulo
authors.initials: P
authors.lastname: Sakai