Effects of octreotide infusion prior to sclerotherapy in esophageal varices

ABSTRACT

Octreotide infusion is usually instituted before injection sclerotherapy to patients having variceal bleed. We studied whether this practice bas any beneficial effects on subsequent sclerotherapy in patients with portal hypertension and liver cirrhosis. Desipn A non-randomized open comparative study. Mace and Duration of Study The study was conducted at Mayo Hospital, Lahore during July to November 1999. fleets and The patients, presenting with first episode of variceal bleed were divided into two groups. Group A patients [n=10] were given octreotide infusions for 48 hours prior to sclerotherapy after a bolus of 50 mcg. Group B patients [n=14] did not receive octreotide due to non-affordability and the injection sclerotherapy was performed within 24 hours of admission. There was no statistically significant difference between the two groups as far as age, systolic blood pressure, hemoglobin and severity of liver disease were concerned. Two groups were compared for blood transfusion requirement, number of sclerotherapy sessions per patient and amount of sclerosant required per patient per session to achieve the satisfactory variceal obliteration. Group A patients required less amount of blood transfusion [1.79 ' 1.41 pint vs 3.0 + 0.8 pint] per case [p <0.01], lesser follow-up sclerotherapy sessions [3.02 ' 0.55 vs 3.21 ' 0.89] per patient [p < 0.05] and less volume of sclerosant [28.6 ' 2.19 ml vs 37.48 ' 6.85 ml], [p < 0.005] per patient per session as well as in all sessions for variceal obliteration [66.00 ' 15.61 ml vs 92. 71 + 12.01 ml], [p < 0.005]. Pre-sclerotherapy infusion of octreotide has added benefits in the management of esophageal variceal bleed