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Longterm outcome of endoscopic sclerotherapy of variceal bleeding: comparative study between schistosomiasis and
M A al Karawi1, A R el-Sheikh Mohamed, A M Ahmed
1Gastroenterology Department Armed Forces Hospital Riyadh, Kingdom of Saudi Arabia.
Background/Aims:
This comparative study was conducted on 111 patients to evaluate the long term outcome of endoscopic variceal therapy in patients with portal hypertension, and particularly with schistosomiasis.
Patients And Methods:
There were 45 patients with chronic liver disease due to schistosomiasis, 31 with chronic hepatitis B and 21 with chronic NNb hepatitis. The remaining 14 had chronic liver disease of other etiologies. The mean follow up period was 40 months.
Results:
Esophageal varices were completely sclerosed in 32 out of 111 patients in 5 sessions (average) over a mean duration of 8 months. A comparison of patients with schistosomal and non-schistosomal liver diseases revealed that 68% of the schistosomal group patients were in child's A classification, compared to 30% of the patients in the non-schistosomal group. There was no significant difference with respect to early rebleeding and recurrence of oesophageal varices. The outcome of sclerotherapy in schistosomal group was better with respect to survival span over a 5 year period of 78% while for the nonschistosomal group it was less than 59%.
Conclusions:
This study has shown that injection sclerotherapy for bleeding oesophageal varices gives best results when liver function is usually well preserved and for chronic schistosomal liver disease.