Endoscopic Injection Sclerotherapy in Patients With Bleeding Esophageal Varices: A Retrospective Analysis

Abstract

Endoscopic injection sclerotherapy has been accepted as the procedure of choice for patients with variceal hemorrhage. To evaluate the efficiency of endoscopic injection sclerotherapy in patients with bleeding esophageal varices, we did a retrospective study of 52 patients (non-sclerotherapy group) with bleeding esophageal varices who were admitted to hospitals and did not receive sclerotherapy and of 50 patients (sclerotherapy group) who received sclerotherapy with ethanolamine oleate. The mortality (sclerotherapy group vs. non-sclerotherapy group: 18:0% vs. 32.7%) during index hospitalization, the bleeding risk factor (the number of rebleeds per patient/month; 1.56±2.76 vs. 4.96±9.99: mean±SEM) and the mortality due to bleeding (14.0% vs. 36.5%) were higher in the non-sclerotherapy group than in the sclerotherapy group. Only those in Child’s class C who received sclerotherapy had a significantly better survival rate than the non-sclerotherapy group (p<0.05). Although formal comparisons were not made because of the retrospective nature of this study, endoscopic injection sclerotherapy is effective and appears to be superior to conventional medical treatments.

Acute Variceal Hemorrhage in Patients with Liver Cirrhosis: Weekend versus Weekday Admissions

“…According to clinical practice guidelines, all patients with cirrhosis and AVH were managed by standard therapy. A combination of vasoconstrictor and endoscopic therapy [band ligation for esophageal variceal bleeding or histoacryl (B. Braun, Tuttlingen, Germany) injection therapy for gastric variceal bleeding], 18 , 19 together with short-term prophylactic antibiotics to prevent spontaneous bacterial peritonitis and other infections 20 were applied as soon as possible after the diagnosis of AVH. 17 …”

Embolic Agents: Sclerotherapy

“…One approach involves the use of a fiberoptic endoscope with a retractable injection needle that allows illumination and visualization of the target varices. 18 First, the apparatus is advanced down the esophagus. When a varix is encountered, the endoscope tip is positioned such that the injector component is flushed against the varix.…”