Early survival after sclerotherapy for bleeding esophageal varices

Forty-two patients from the University of Minnesota Hospitals and Minneapolis Veterans Administration Hospital underwent sclerotherapy for endoscopically verified esophageal varices. No patient was excluded because of poor hepatic functional reserve or serious co-morbid condition. Eleven patients were actively bleeding at the time of sclerotherapy. Thirty-one were listed as Child class B and C. After sclerotherapy, six of 25 survivors have had obliteration of varices. Substantial improvement was noted endoscopically in eight others. The most frequent complication was rebleeding, which occurred in 20 patients. Rebleeding led to surgical intervention in seven and to seven nonoperative deaths. There were two instances of mesenteric venous thrombosis complication not previously described following sclerotherapy. Twenty-nine patients survived two months, and 16 patients are alive at six months. These figures compare quite favorably with survival figures from other groups of patients who had roughly comparable liver impairment and who underwent medical treatment or portacaval shunts as an emergency measure.