Emergency sclerotherapy vs. medical interventions for bleeding oesophageal varices in cirrhotic patients

Emergency sclerotherapy as the first, single treatment is not effective compared with vasoactive drugs.

A Cochrane review included 17 studies with a total of 1 817 subjects. The medical interventions included octreotide (10 studies), somatostatin (5 studies), terlipressin (1 study) and vasopressin (1 study). No significant differences were found comparing sclerotherapy with each vasoactive drug for any outcome. Combining all the trials irrespective of the vasoactive drug, the risk differences were for failure to control bleeding (16 RCTs) -0.02 (95% CI -0.06 to 0.02), five-day failure rate (9 RCTs) -0.05 (95% CI -0.10 to 0.01), rebleeding (16 RCTs) 0.01 (95% CI -0.03 to 0.05), and mortality (17 RCTs) -0.02 (95% CI -0.06 to 0.02). Adverse events (RD 0.08, 95% CI 0.03 to 0.14; 12 studies) and serious adverse events (RD 0.05, 95% CI 0.02 to 0.08; 5 studies) were significantly more frequent with sclerotherapy.

Ədəbiyyat

1. D'Amico G, Pagliaro L, Pietrosi G, Tarantino I. Emergency sclerotherapy versus vasoactive drugs for bleeding oesophageal varices in cirrhotic patients. Cochrane Database Syst Rev 2010;(3):CD002233. .