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Results of a Prospective Randomized Controlled Trial

Alan W. Larson, MD; Hartley Cohen, MD; Bruce Zweiban, MD; David Chapman, MD; Maurice Gourdji, MD; Jacob Korula, MD; John Weiner, DrPH

JAMA. 1986;255(4):497-500.

Abstract
Within 48 hours of variceal hemorrhage, 82 patients were randomly assigned to conventional treatment including balloon tamponade or to conventional treatment supplemented by sclerotherapy. The prerandomization general clinical characteristics of the two groups were similar. Seventy-nine percent of patients were alcoholic and 57% were in Child's class C. In the sclerotherapy group of 44 patients, sclerotherapy was performed twice in 28 patients and thrice in 13 patients over the two weeks of follow-up. The number of patients who rebled was significantly lower in the sclerotherapy group than in the group treated conventionally (23% vs 53%). The number of bleeding episodes also was significantly lower in the sclerotherapy group (15 vs 32). Moreover, blood transfusion requirements were significantly decreased in the sclerotherapy group. This was true even for patients who were bleeding at the time of randomization or who were in Child's class C, but this primarily was because fewer patients who underwent sclerotherapy (10 of 24 vs 18 of 23) required transfusions. Although there was no difference in survival between the two groups, we conclude that sclerotherapy is better than conventional treatment in the acute management of variceal bleeding.

(JAMA 1986;255:497-500)

Author Affiliations
From the Sections of Gastroenterology and Hepatology, Department of Medicine, University of Southern California School of Medicine, Los Angeles.

Footnotes
Reprint requests to Gastroenterology Section, Department of Medicine, University of Southern California School of Medicine, 2025 Zonal Ave, Los Angeles, CA 90033 (Dr Cohen).

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