Increased Long-Term Survival in Variceal Haemorrhage Using Injection Sclerotherapy

Macdougall, B.R.D.; Theodossi, A; Westaby, David; Dawson, J. L.; Williams, Roger

doi:10.1016/s0140-6736(82)90378-6

Cited by 267 publications

(72 citation statements)

References 11 publications

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“…They can be divided into those occurring at the site of injection (mostly ulcerations and esophageal fibrosis [20]) and into those originating from injection and systemic dissemination of the sclerosant (mostly fever, bacteremia [72,76], or pulmonary side effects [32,52,71]). In prospective therapeutic clinical trials [38,47,58,73,77,78,[87][88][89]94] fatal complications ranged between 0% and 13% (median 2.5%), mostly caused by perforation of the esophagus, aspiration pneumonia, and bleeding esophageal ulcers. Although the risk of fatal complications is supposed to be lower in patients undergoing elective sclerotherapy, it has to be kept in mind that 1% to 2% of the patients may die by endoscopic prophylaxis.…”

Section: Prophylactic Sclerotherapymentioning

confidence: 99%

Prophylaxis of first variceal hemorrhage in patients with liver cirrhosis

et al. 1986

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Summary. Prophylaxis of bleeding from esophageal varices is a very tempting concept at first glance, especially under the assumption of a high mortality associated with first variceal hemorrhage. Up to now four different measures have been tried for prophylaxis: portacaval shunt operation, devascularization procedures, sclerotherapy, and drugs. With the exception of portacaval shunts, ongoing controlled trials show a weak trend toward reduction of variceal bleeding and prolongation of survival in selected patients with compensated cirrhosis and large varices. However, prophylaxis of first variceal bleeding must still be regarded as experimental and should be restricted to controlled clinical studies.

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Section: Prophylactic Sclerotherapymentioning

confidence: 99%

Prophylaxis of first variceal hemorrhage in patients with liver cirrhosis

et al. 1986

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“…Repeated injections, after initial presentation, reduce the incidence of rebleeding from varices, but have not yet been shown to conclusively reduce the mortality (46,47). Although the Kings College Hospital Study (47) showed an apparent reduction in the mortality with repeated sclerotherapy, the control group generally did not undergo surgery or sclerotherapy.…”

Section: ) Endoscopic Variceal Sclerosis D Clements and E Eliasmentioning

confidence: 99%

“…Although the Kings College Hospital Study (47) showed an apparent reduction in the mortality with repeated sclerotherapy, the control group generally did not undergo surgery or sclerotherapy. Thus the trial compared repeated sclerotherapy with conservative treatment, rather than the additional benefit of repeated sclerosis over sclerotherapy alone for the acute episode.…”

Section: ) Endoscopic Variceal Sclerosis D Clements and E Eliasmentioning

confidence: 99%

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1985

Journal of Clinical Pharmacy and Therapeutics

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“…Today sclerotherapy is emerging in many centers, particularly in Europe, as the treatment of choice for esophageal varices. [1][2][3][4][5][6] Sixty percent of hospitalized patients with bleeding esophageal varices initially controlled by conservative measures will rebleed and 60% of those who rebleed will die during their first hospital admission. 1,7,8 Sclerotherapy was introduced in 1939 9 to combat the problem but was quickly abandoned in favor of portosystemic shunting, which remained the treatment of choice for the next 30 years.…”

Section: Introductionmentioning

confidence: 99%

“…It stops bleeding, 2 prevents rebleeding, 3,4 and improves survival statistics. 4 Prophylactically it seems to decrease the risk of hemorrhage and improve survival in selected patients.…”

Section: Introductionmentioning

confidence: 99%

Sclerotheraphy for Esophageal Varices: A Retrospective Study of 61 Patients Treated at King Faisal Specialist Hospital

et al. 1984

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Over a period of 36 months, 61 patients underwent sclerotherapy for esophageal varices, 49 after a variceal bleeding episode (Group I) and 12 selected patients prophylactically (Group II). Mean follow-up was 12.6 months in Group I and 15.5 months in Group II. In Group I 27% died; only 10% of those patients presenting with mild liver disease (Child's Group A) who were followed died of gastrointestinal hemorrhage; but all presenting with severe liver disease (Child's Group C) died after a mean of 6.3 months, 57% following rebleeding. No patients in Group II died from esophageal hemorrhage. The rebleeding risk per patient-month of follow-up was 0.04 in Group I, 0.005 in Group II and 0.01 in the 22% of patients in Group I who achieved complete ablation of their varices. There was no mortality attributable to the procedure, and complications occurred after only 4.5% of the procedures; all were reversible. Sclerotherapy seems at present the treatment of choice for bleeding esophageal varices, considering its efficacy, safety and simplicity. It is probably also of value prophylactically in selected patients.

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Increased Long-Term Survival in Variceal Haemorrhage Using Injection Sclerotherapy

Cited by 267 publications

References 11 publications

Prophylaxis of first variceal hemorrhage in patients with liver cirrhosis

Prophylaxis of first variceal hemorrhage in patients with liver cirrhosis

Untitled

Sclerotheraphy for Esophageal Varices: A Retrospective Study of 61 Patients Treated at King Faisal Specialist Hospital

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