A comparison of two different dosages of somatostatin combined with sclerotherapy for the treatment of acute esophageal variceal bleeding: a prospective randomized trial

Background: the association of somatostatin (SMT) with endoscopic therapy in patients with cirrhosis and variceal bleeding significantly improves the control of the bleeding episode, and hemodynamic data have shown that a dosage of 500 µg/h allows a more marked reduction of portal pressure versus the usual dosage of 250 µg/h. Aim: to assess if the 500 µg/h dosage is associated with an improved outcome. Methods: sixty-two patients with variceal bleeding were included in the study. Patients were randomized to receive the usual dosage of SMT (group I: 250 µg/h), or a double dosage (group II: 500 µg/h), together with emergency endoscopic sclerotherapy. Results: the control of the bleeding episode was similar in both groups of patients. Early rebleeding was less frequent in patients receiving double vs. single dosage of SMT (p = 0.06). When considering patients with advanced liver disease (Child-Pugh B or C) early rebleeding was significantly less frequent in patients receiving the 500 µg/h dose of SMT (39 vs. 13%, p = 0.03). Conclusions: the perfusion of higher doses of SMT (500 µg/h) in association with emergency sclerotherapy in patients with cirrhosis and esophageal hemorrhage significantly decreases the rate of early rebleeding in patients with more advanced stages of liver disease.

Bibliographic Details

Main Authors:	Palazón,J. M., Such,J., Sánchez-Payá,J., Company,L., Madaria,E. de, Sempere,L., Martínez,J., Zapater,P., Pascual,S., Carnicer,F., Pérez-Mateo,M.
Format:	Digital revista
Language:	English
Published:	Sociedad Española de Patología Digestiva 2006
Online Access:	http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082006000400004
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