Endoscopic sclerotherapy of oesophageal varices due to hepatosplenic schistosomiasis. A randomized controlled trial evaluating the effect of adjuvant propranolol therapy

Abstract

The relative high incidence of rebleeding during the course of injection sclerotherapy requires attempts at its improvement. Forty consecutive patients with bleeding oesophageal varices underwent either injection sclerotherapy only or injection sclerotherapy with an adjuvant fixed daily dose of propranolol (40 mg tds) in a single-blind randomized controlled trial. They were injected on a weekly basis until varices were eradicated at which time propranolol was withdrawn. Patients were then followed-up for a period of two years. The results showed that ad to a decline in resting pulse rate by a median of 23.9%. Patients undergoing injection sclerotherapy with adjuvant propranolol required fewer injection sessions for variceal eradication than patients undergoing injection sclerotherapy alone (8 versus 11: p > 0.05). Patients undergoing injection sclerotherapy with adjuvant propranolol experienced more variceal recurrences than those undergoing injection sclerotherapy alone (25% versus 13.3%, p > 0.05). Five of 20 patients undergoing sclero-therap with adjuvant propranolol rebleed as compared to 6 of 20 y patients undergoing injection sclerotherapy only (p > 0.05). The probability of rebleeding and survival was similar in both groups (p > 0.05).