ABSTRACT
To study the efficacy of oesophageal band ligation versus use of beta -blockers for primary prophylaxis of 1st variceal bleed in portal hypertension Randomized controlled trial Place and duration of study: At department of Medicine and Gastroenterology, Combined Military hospital Rawalpindi, during June 2006 to June 2007 Sixty eight patients with portal hypertension were included in the study after screening endoscopy. All the patients were divided in two groups, A and B. Group A patients underwent oesophageal band ligation and patients in group B were given beta -blockers for primary prophylaxis. Each group contained equal number of 34 patients to start with but in the very first week, 6 patients in group B could not tolerate beta blockers. They were switched to group A treatment. These patients were followed up for next one year Group A patients who underwent band ligation had significantly reduced incidence of 1st variceal bleed[p value=0.020] as compared to group B who received beta -blockers. As far as mortality is concerned there was no significant difference [p=0.067] was noted between the two groups. The oesophageal band ligation is superior to beta -blockers in preventing 1st oesophageal variceal bleed but no difference in mortality was noted whichever prophylaxis was used in this study