Outcome of endoscopic injection sclerotherapy with absolute alcohol for bleeding esophageal varices

ABSTRACT

Objective:To find out the long-term consequences of endoscopic injection sclerotherapy using absolute alcohol as a sclerosing agent. Design: Study was carried out retrospectively. Place and DurationDepartment of Gastroenterology, HMC, Peshawar from January, 1988 to June, 2000. Subject and 620 patients admitted for bleeding esophageal varices were studied, emergency sclerotherapy was performed in 127 [20.48%] patients whereas elective sclerotherapy was performed after 24- 72 hours in 493 [79.52%] patients [p < 0.05]. Total sclerosis with survival was achieved in 573[92.41%] patients [p < 0.05], whereas 47[7.58%] patients died because of uncontrolled bleeding in 31[5%] patients, early rebleeding in 9[1.45%] patients, and encephalopathy in 7[1.12%] patients. Common complications included central chest pain [17%], esophageal ulceration [11%] and pyrexia [5%]. At the time of discharge from hospital, all the patients were given propranolol 20 mg QID as an adjuvant medical therapy for the secondary prophylaxis of variceal bleeding. The rate of complete eradication of esophageal varices was 92%. The overall recurrence rate of varices was 28% during follow-up period. The rate of recurrent bleeding and death was 9.42% and 3% respectively. We conclude that absolute alcohol and propranolol for bleeding esophageal varices are associated with low recurrence rate of varices, rebleeding and low mortality