Emergency Endoscopic Variceal Ligation versus Somatostatin for Acute Esophageal Variceal Bleeding

作者：Wen‐Chi Chen, Gin‐Ho Lo, Wei‐Lun Tsai, Ping‐I Hsu, Chiun‐Ku Lin, Kwok‐Hung Lai · 发表于：Journal of the Chinese Medical Association · 年份：2006 · DOI：10.1016/s1726-4901(09)70115-7 · 被引用次数：29 · 研究领域：Liver Disease and Transplantation、Gastrointestinal Bleeding Diagnosis and Treatment、Esophageal and GI Pathology

BACKGROUND: Endoscopic variceal ligation and somatostatin are widely used for treating acute esophageal variceal bleeding. This study compared the efficacy, safety, and survival of both therapies. METHODS: Acute esophageal variceal bleeding patients were randomized to undergo emergency ligation or receive a bolus of 250 microg somatostatin plus infusion at 250 microg/hour for 48 hours and undergo ligation subsequently. RESULTS: Three (4.8%) of 62 patients in the ligation group and 20 (31.7%) of 63 patients in the somatostatin group encountered treatment failure (p = 0.0001). Transfusion requirements were 4.7 +/- 3.2 units in the ligation group and 6.9 +/- 7.3 units in the somatostatin group (p = 0.03). Hospital stay was 7.7 +/- 4.0 days in the ligation group and 10.2 +/- 9.9 days in the somatostatin group (p = 0.07). Adverse effects occurred in the ligation group (20 episodes) and the somatostatin group (27 episodes) (p = 0.2). The 42-day mortality rates were 5 patients (8.1%) in the ligation group and 3 patients (4.8%) in the somatostatin group (p = 0.5). CONCLUSION: Emergency ligation was superior to somatostatin in treating acute esophageal variceal bleeding, with fewer requirements of transfusion and a tendency toward shorter hospital stay. The adverse effects and 42-day mortality rates were similar between both treatments.