Chronic therapy in bleeding esophageal var ices by endoscopic banding combination with propranolol

Abstract

Background : Bleeding esophageal varices is the common complication in cirrhotic patients. Their rebleeding is frequent and the mortality rate from variceal bleeding is about 20-30 percent. Now, long term endoscopic treatment combination with or without pharmacotherapy is the first choice of modality for secondary prophylaxis of bleeding esophageal varices. In chronic therapy, the variceal eradication program has been using at Prapokklao Hospital for 3 years, but the benefit and outcome has never been evaluated.

Objective : To evaluate efficacy of endoscopic banding combination with propranolol for long term follow up in bleeding esophageal varices patients

Method : Medical records of all patients who presented with bleeding esophageal varices and were treated by endoscopic banding from October 2004 to September 2007 were retrospectively reviewed. Data of sex, age, the number of banding sessions,rebleeding rate, dead cases and the cause of dead in subgroup of patient who followed up for more than 10 months were collected and analyzed to access long term results.

Result : Ninety seven patients were examined for long term results. Fifty one patients were Group I who had long term follow up and forty six patients were Group II who loss follow up. Sex ratio male/female was about 2.19 and 2.29. The majority of age group was below 50 years old (45.1 percent and 50.0 percent) which was no significant difference between both group. In group I, varices eradicaton rate was 82.27 percent,the number of session to achieve eradication was 4 to 5 (86.36 percent). The rebleeding rate in Group I was 3.93 percent and Group II was 93.47 percent respectively. The dead rate from bleeding varices in Group I (1.96 percent) and Group II (19.57 percent) were significant difference (p<0.05)

Conclusion : Long term endoscopic banging treatment combination with propranolol (chronicterapy)