Wazir Muhammad Shaikh, Sher Muhammad Shaikh, Majid Ahmed Shaikh, Ghulam Akber Solangi, Zuberi B F.
A comparative study of efficacy of Octreotide and Sclerotherapy in Variceal Bleeding.
J Coll Physicians Surg Pak Jan ;12(11):677-81.

Objective: To see the efficacy of octreotide and sclerotherapy and combination thereof in control of variceal bleeding. Design: A prospective, open-label randomised study. Place and Duration of Study: Department of Medicine, Chandka Medical College, Larkana and Lateef Medical Complex, Larkana, Pakistan. Patients and Methods: This study was conducted from June, 1996 to June, 2001. In all, 564 patients were included in the study, 188 received sclerotherapy alone (group I), 196 sclerotherapy with octreotide (group II) and rest (180) were put on octreotide alone (group III). The patients of all groups were comparable regarding baseline characteristics and severity of disease. Sclerotherapy was given on day 1,8,15 and 29. Each varix was injected with 4-6 ml of ethanolamine separately at the same sitting. The octreotide was given 50 mcg/hour through infusion for 48 hours and then subcutaneously 8 hourly for total 5 days. All the patients were observed for 30 days. Results: In group I, 48 patients (25.53%) showed re-bleeding, whereas in group II and III re-bleeding was noted in 20 patients (10.2%) and 24 patients (13.33%) respectively. The difference was statistically significant p < 0.01. The re-bleeding was remarkable in Child-Pugh`s group B and C. Twelve patients (6.3%) died in group I, while 4 died in each group II (2.04%) and III (2.22%) respectively. The difference was statistically significant (p 0.03). Conclusion: Octreotide appeared equally or superior over sclerotherapy in controlling bleeding and preventing early re-bleeding.

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