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Does propranolol maintain post-sclerotherapy variceal obliteration? A prospective randomized study

G H Lo1, K H Lai, S D Lee

  • 1Department of Medicine, Veterans General Hospital-Kaohsiung, Taiwan, Republic of China.

Journal of Gastroenterology and Hepatology
|July 1, 1993
PubMed
Summary

Propranolol did not prevent esophageal variceal recurrence or rebleeding after injection sclerotherapy. This beta-blocker did not improve outcomes in patients treated for variceal bleeding.

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Area of Science:

  • Gastroenterology
  • Hepatology
  • Clinical Pharmacology

Background:

  • Esophageal variceal bleeding is a serious complication of portal hypertension.
  • Injection sclerotherapy is a common treatment, but recurrence and rebleeding rates remain high.
  • The potential role of beta-blockers like propranolol in maintaining sclerotherapy's efficacy is unclear.

Purpose of the Study:

  • To evaluate the effectiveness of propranolol in maintaining variceal obliteration after successful injection sclerotherapy.
  • To assess whether propranolol reduces the risk of variceal recurrence and rebleeding in patients previously treated with sclerotherapy.

Main Methods:

  • A randomized controlled trial involving 59 patients with a history of esophageal variceal bleeding.
  • Patients received either propranolol or served as controls after initial variceal obliteration by sclerotherapy.
  • Follow-up was conducted for a mean of 2 years and 4 months to monitor for variceal recurrence and bleeding events.

Main Results:

  • No significant difference in variceal recurrence rates between the propranolol group (58%) and the control group (77%) (P = 0.20).
  • Similar rates of recurrent variceal bleeding were observed: 27% in the propranolol group versus 19% in the control group.
  • Cardiac varices developed in 15% of the propranolol group and 11% of the control group, with most fatal bleeding originating from these sites.

Conclusions:

  • Propranolol administration following injection sclerotherapy does not prevent the recurrence of esophageal varices.
  • The use of propranolol in this setting does not significantly reduce the incidence of rebleeding from esophageal varices.
  • Survival rates were similar between the groups, suggesting propranolol does not offer a survival benefit in this specific post-sclerotherapy context.