Endoscopic ligation vs. nadolol in the prevention of first variceal bleeding in patients with cirrhosis.

摘要: Abstract Background The value of band ligation for prevention the first episode variceal bleeding has not been fully evaluated. This study compared efficacy and safety vs. treatment with a beta-blocker prophylactic in patients cirrhosis high-risk esophageal varices. Methods A total 100 endoscopically determined varices but no history were randomized to (50 patients) or nadolol patients). In group, two 4 elastic bands deployed during each session. Ligation was repeated at intervals 3 weeks until obliteration achieved. dose drug, administered once daily, sufficient reduce pulse rate by 25%. Results achieved 41 (82%), mean 2.7 (1.1) sessions. daily 60 (20) mg. During follow-up (median approximately 22 months), 10 (20%) group 16 (32%) had upper-GI ( p =0.23). Esophageal occurred 5 (10%) 9 (18%) =0.31). By multivariate Cox analysis, Child-Pugh class only factor predictive bleeding. Minor complications noted (8%) =0.35). No serious complication encountered. Twelve 11 died =0.62). One patient from uncontrollable hemorrhage. Conclusions Variceal is as effective safe cirrhosis.