Course and complications of endoscopic variceal sclerotherapy: a prospective study of 50 patients

Abstract

Fifty consecutive patients with bleeding esophageal varices were treated with endoscopic variceal sclerotherapy (EVS) using the free hand method and a flexible fiberoptic endoscope. During the study period, November 1981 through April 1984, 11 patients (22%) rebled after the initiations of EVS and six patients were lost to follow-up. Obliteration of esophageal varices was achieved in 14 patients and none of these patients rebled for a mean follow-up time of 305 days. Survival curves generated by Willcoxson life table analysis demonstrated 51% 1-year survival for all patients, 21% for Child's class C patients, and 100% for Child's A and B patients. The complications associated with EVS were ulcerations 78%, strictures 20%, fever 44%, and perforations 2%. This study indicates that EVS is a safe and effective treatment for acute variceal hemorrhage and obliteration of esophageal varices can be achieved. Once varices are obliterated rebleeding may not occur. Survival in Child's A and B patients may be improved with EVS but the survival in Child's C patients is unaffected.