Summary
Of 60 patients suffering from various stages of esophageal varices with no previously
recorded bleeding, 30 underwent combined peri- and intravascular fiberscopic sclerotherapy
in a prospective controlled study. Each of the two groups consisted of 22 men and
8 women with an average age of 49 years. The cause of portal hypertension in 58 patients
was a morphologically proven cirrhosis of the liver, due mainly to alcoholism. Portal
vein thrombosis was present in two patients. The severity of the liver disease was
first evaluated in accordance with the PUGH modification of the CHILD classification.
53 % of the patients in the control, and 56 % in the treatment, group belonged to
the prognostically favourable CHILD A category. The period of observation was at least
26 months, with a mean of 36 months. Sclerotherapy lowered the risk of bleeding to
13.3 %; in the control group it was 30 %. The mortality rate during the overall observation
period was lowered significantly (p < 0.05) by sclerotherapy to 5.9 % in the CHILD
A group as compared with 25 % in the control group. The mortality rate of CHILD B
and C patients was over 40 % in the control group and an unequally large 70 % in the
treatment group. The most frequent cause of death was bleeding from esophageal varices
in the control group and liver failure in the treatment group.
Complications were seen in 20 % and paralleled the severity of the esophageal varices.
All complications responded to conservative treatment and no fatality was seen.
Key words:
Esophageal varices - Prophylactic sclerotherapy - Controlled study
