Abstract

INFANTE VELAZQUEZ, Mirtha et al. Endoscopic variceal ligation plus propranolol for secondary prophylaxis of gastrointestinal bleeding in cirrhotic patients. Rev Cub Med Mil [online]. 2013, vol.42, n.1, pp. 39-48. ISSN 0138-6557.

Introduction: the combination of endoscopic ligation of esophageal varices along with beta blockers drugs is the treatment of choice for secondary prophylaxis of bleeding. Objective: to determine the probability of occurrence of an episode of recurrent bleeding in a group of patients who received a combination therapy, and if this recurrence is related or not to the cause of cirrhosis or to the degree of hepatocellular dysfunction. Methods: adescriptive, prospective and longitudinal study was conducted. Survival curves were constructed taking as rebleeding as an event. Comparison was performed according to the cause and disease status according to Child-Pugh stage. Results: 23 patients were included: 56.5 % male and 43.5 % female. The main cause of cirrhosis was hepatitis C virus infection (52.2 %). Seven patients (30.4 %) were in stage A of Child; 10 (43.5 %) in B and 6 (26.1 %) in C. 3.47 average ligation sessions were performed and 97.39 mg was the mean dose of propranolol administered. All patients had their varices eliminated. The overall rebleeding rate was 13.04 %. 34.8 % of cases suffered worsening or occurrence of hypertensive gastropathy. The cumulative probability of survival was 95.2 % at three months, 87.9 % at 11 months and 79.1 % at 14 months. No differences in survival were found related to the cause (p = 0.749), but there were found differences according to Child stage (p = 0.002). Conclusions: the assessed combination therapy is useful to eliminate and prevent recurrent variceal bleeding.

Keywords : cirrhosis; banding; esophageal varices; propranolol.

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