COURSE AND COMPLICATIONS OF ENDOSCOPIC VARICEAL SCLEROTHERAPY - A PROSPECTIVE-STUDY OF 50 PATIENTS

Abstract

Fifty consecutive patients with bleeding esophageal varices were treated with endoscopic variceal sclerotherapy (EVS) using the free hand method and a flexible fiberoptic endoscope. During the study period, Nov. 1981-April 1984, 11 patients (22%) rebled after the initiations of EVS and 6 patients were lost to follow-up. Obliteration of esophageal varices was achieved in 14 patients and none of these patients rebled for a mean follow-up time of 305 days. Survival curves generated by Willcoxson life table analysis demonstrated 51% 1 yr survival for all patients, 21% for Child''s class C patients and 100% for Child''s A and B patients. The complications associated with EVS were ulcerations 78%, strictures 20%, fever 44% and perforations 2%. EVS is apparently a safe and effective treatment for acute variceal hemorrhage and obliteration of esophageal varices can be achieved. Once varices are obliterated rebleeding may not occur. Survival in Child''s A and B patients may be improved with EVS but the survival in Child''s C patients is unaffected.