Format

Send to

Choose Destination
See comment in PubMed Commons below
Acta Gastroenterol Latinoam. 2013 Jun;43(2):89-97.

[Endoscopic versus endoscopic plus octreotide treatment for acute variceal bleeding. Benefit according to severity at admission].

[Article in Spanish]

Author information

1
Servicio de Terapia Intensiva, Hospital de GastroenterologĂ­a "Dr Carlos Bonorino Udaondo", Buenos Aires, Argentina. julioberreta@googlemail.com

Abstract

Vasoactive agents plus endoscopic treatment was recommended in esophageal variceal bleeding (EVB). However, the use according to severity on admission has been poorly evaluated

OBJECTIVES:

To evaluate the efficacy of endoscopic versus endoscopic plus octreotide treatment in patients with EVB according to severity on admission.

METHODS:

Between June 2001 and December 2011, 247 patients with EVB were treated using endoscopic or combined endoscopic plus octreotide treatment. Patients were analyzed according to the following cohorts: all patients, those with and without active bleeding, and by Child classes. Initial hemostatic failure, in-hospital rebleeding and in-hospital mortality were compared with both treatments.

RESULTS:

All patients with combined treatment had less initial hemostatic failure (P = 0.0157) and rebleeding (P = 0.0011) when compared to endoscopic treatment. Active bleeding patients and Child C patients had a significant reduction of initial hemostatic failure when receiving combined treatment vs endoscopic treatment (P = 0.0479 and P = 0.0222, respectively). Child C patients and patients without active bleeding significantly decreased rebleeding with combined treatment (P = 0.0139 and P = 0.0056, respectively). Global mortality was 17%, and did not differ between treatments. None patient in Child A died.

CONCLUSIONS:

Combined endoscopic plus octreotide treatment in patients with EVB resulted in a reduction of initial hemostatic failure and rebleeding. Moreover, the most relevant effect of combined treatment in decreasing initial hemostatic failure was seen in Child C and active bleeding patients, and for in-hospital rebleeding the same effect was seen in Child C and in patients without active bleeding. Mortality did not differ with both mentioned treatments.

PMID:
23940908
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Loading ...
    Support Center