Prophylactic sclerotherapy in high-risk cirrhotics selected by endoscopic criteria. A multicenter randomized...

Area of Science:

• Hepatology
• Gastroenterology

Background:

• Variceal hemorrhage is a serious complication of cirrhosis.
• Previous studies on sclerotherapy for preventing first variceal bleeding have yielded conflicting results.

Purpose of the Study:

• To evaluate the efficacy of prophylactic sclerotherapy in preventing the first variceal hemorrhage in patients with cirrhosis.

Main Methods:

• A randomized controlled trial involving 106 cirrhotic patients with high-risk varices and no prior bleeding history.
• Patients were assigned to either sclerotherapy (55) or a control group (51).
• Sclerotherapy was administered at intervals until eradication, with follow-up endoscopies every 6 months.

Main Results:

• Variceal bleeding occurred in 34.5% of the sclerotherapy group and 35.4% of the control group (P = NS).
• Overall mortality was not significantly different between groups (34.5% vs. 50%).
• However, bleeding-related mortality was lower in the sclerotherapy group (36.8%) compared to controls (64.7%, P < 0.05).

Conclusions:

• Prophylactic sclerotherapy does not reduce the incidence of first variceal bleeding in cirrhotic patients.
• A trend suggests lower bleeding-related mortality in patients receiving prophylactic sclerotherapy.