Sclerotherapy versus propranolol in prophylaxis of oesophageal varices bleeding

Abstract

Bleeding from ruptured oesophageal varices is one of the major health problems in Egypt and result in great morbidity and mortality. Prophylaxis of haemorrhage from oesophageal varices in patients with liver cirrhosis aims at improving life expectancy by lowering the risk of this life threatening events. The majority of studies on pnmary prophylaxis with propranolol in cirrhotic patients showed significant effect on the incidence of variceal haemorrhage. In secondary prophylaxis, sclerotherapy as well as long term oral administration of propranolol represent effective strategies. • The aims of the present study were:

1. To detect the role of propranolol m prevention of initial bleeding from oesophageal varices. 2. To compare the effectiveness of sclerotherapy and administration of

propranolol in prevention oesophageal varices rebleeding.

3- To compare the effectiveness of sclerotherapy-propranolol combination and sclerotherapy alone or propranolol alone in secondary prophylaxis of oesophageal varices bleeding.

• The study was conducted on 302 patients, 150 of them for primary prophylaxis and 152 patients for secondary prophylaxis. • Primary prophylaxis group was subdivided into two groups : Group I: patients with liver cirrhosis and oesophageal varices with no past history of bleeding from oesophageal varices and under propranolol therapy.