Chonnam Med J.  2006 Aug;42(2):79-84.

Clincal Analysis of the Effectiveness of the Terlipressin Combined with Endoscopic Variceal Ligation in Acute Esophageal Variceal Bleeding

• Park KJ
• Kim DH
• Kim SH
• Cho SB
• Park HC
• Joo SY
• Park SY
• Lee WS
• Park CH
• Joo YE
• Kim HS
• Choi SK
• Rew JS
• Kim SJ

Abstract

Terlipressin is widely used in acute variceal bleeding to reduce the bleeding. It acts by constricting mesenteric arteries, thus reducing portal venous flow and portal pressure. This study was tried to assess the efficacy and safety of terlipressin combined with endoscopic variceal ligation (EVL) in acute esophageal variceal bleeding and to evaluate clinical risk factors related to rebleeding. 43 patients with acute esophageal variceal bleeding received terlipressin (2 mg i.v. initially and 1 mg i.v. every 4 hours for 3 days) combined with EVL. Initial hemostasis rate was 98% (42/43 cases). 5-day and 42-day cumulative rebleeding rates were 12% (5/43 cases) and 28% (12/43 cases). The rebleeding sites were other esophageal varix (58%), EVL-induced ulcer (33%) and combined gastric varix (8%). The mortality rate within 6 week was 14%. The clinical factor related to rebleeding was poor liver function (Child-Pugh class C). Terlipressin combined with EVL is effective and safe in the treatment of acute esophageal variceal bleeding.

Keyword

Terlipressin; Esophageal varices; EVL (endoscopic variceal ligation)

MeSH Terms

Esophageal and Gastric Varices*
Hemorrhage
Hemostasis
Humans
Ligation*
Liver
Mesenteric Arteries
Mortality
Portal Pressure
Risk Factors
Ulcer