Summary
Endoscopic sclerotherapy in active variceal bleeding stopped bleeding in 48 out of
67 patients (72 %). Survival of the acute bleeding episode was related to liver function:
6 % mortality in Child A patients vs. 48 % mortality in Child C. Comparing two treatment
modalities: 24 h Linton balloon tamponade followed by sclerotherapy vs. sclerotherapy
alone, our results in comparable groups slightly, although not significantly, favor
tamponade-sclerotherapy treatment: 75 % survival vs. 71 %. As this treatment modality
is more convenient and helps to avoid dangerous aspiration pneumonia, we advocate
balloon tamponade prior to sclerotherapy in acute variceal bleeding.
In maintenance treatment 65 patients were treated until eradication of varices. The
rebleeding risk was 0.034 % per patient per month, with 64 % of the rebleeding within
the 2 first months before complete eradication of the varices. The long-term survival
depends largely on liver function: one year survival of 88 % in Child A vs. 30 % in
Child C.
Using Aethoxysklerol 1 % in intravariceal injection, no stricture occurred. Using
a sterile injection needle and a glutaraldehyde-disinfected endoscope, no infectious
complications directly related to the procedure occurred, and all hemocultures remained
negative.
Key words:
Esophageal varices - Endoscopic sclerotherapy - Balloon tamponade - Disinfection in
endoscopy
