Comparison of Endoscopic Ligation and Propranolol for the Primary Prevention of Variceal Bleeding / 대한소화기내시경학회지

ABSTRACT

BACKGROUND/AIMS: Although there were many studies to prevent recurrent variceal bleeding, studies about primary prophylaxis of variceal bleeding have been relatively few. We retrospectively evaluated the efficacy of endoscopic variceal ligation (EVL) and propranolol therapy for primary prevention. METHODS: 64 patients who underwent EVL or received propranolol for primary prophylaxis were enrolled and these patients were in the state of Child A or B with large varices and/or red markings on varices. We compared the cumulative bleeding-free rate and the survival rate between EVL group (n=40) and propranolol group (n=24) for primary prophylaxis. RESULTS: The Child classification, the size of varices, and the presence of red color sign were not different statistically between both groups. The mean duration of follow-up in each group was 44 18 and 22 12 months, respectively (p=0.023). The cumulative bleeding- free rate was high in EVL group than in propranolol group (p=0.03). The cumulative survival rate was not different statistically between both groups. CONCLUSIONS: In patients with high-risk varices, EVL therapy prolonged bleeding-free interval compared with propranolol therapy for the primary prophylaxis of variceal bleeding.