Combined Therapy of Endoscopic Variceal Ligation and beta-Blocker for Esophageal Varices

Lee, Ok Jae

Abstract

BACKGROUND AND AIMS
Endoscopic variceal ligation (EVL) has been accepted as safe and useful treatment for esophageal varices. However, the main problem is the recurrence after eradication of varices.beta-blockers have been shown to be effective for prevention of vari-ceal bleeding. We evaluate the efficacy of the combined therapy of EVL and beta-blocker against recurrence of esophageal varices.
METHODS
39 patients followed from October 1992 through February 1998 after eradication of esophageal varices by EVL were divided into two groups: group 1; 20 patients received EVL alone, group 2; 19 patients received EVL and propranolol for follow-up periods. The rate of recurrence and rebleeding were observed in two groups.
RESULTS
Follow-up periods in group 1 and 2 after an initial eradication of esophageal varices were 1039.6 (291-1499) and 928.3 (448-1793) days, re-spectively. During follow-up periods, the recurrence rate was lower in group 2 (27.8%) than group 1 (60.0%) (p <0.05). The periods from last session to recurrence were 609.1 (128-1460) and 666.2 (405-1007) days in group 1 and 2, respectively. The rebleeding and mortality rates were 15.0% and 25.0% in group 1.
CONCLUSIONS
Combined therapy of EVL and beta-blocker could decrease the recurrence rate after eradication of esophageal varices, as compared with EVL alone. The further large, long-term study should be re-quired.