Does propranolol maintain post-sclerotherapy variceal obliteration? A prospective randomized study


Gin-Ho Lo, MD, Division of Gastroenterology, Department of Medicine, Veterans General Hospital-Kaohsiung, 386 Ta-Chung 1st Rd, Kaohsiung 813, Taiwan, Republic of China.


Variceal recurrence and rebleeding are common after initial obliteration by injection sclerotherapy. To investigate whether propranolol can maintain variceal obliteration by sclerotherapy, 59 patients with oesophageal variceal bleeding after sclerotherapy were enrolled. Patients were allocated to propranolol treatment (30 patients) or served as controls (29 patients). After a mean follow up of 2 years and 4 months, 53 patients completed the study. Fifty-eight per cent of the propranolol group versus 77% of the control group experienced recurrent varices (P= 0.20). Fifteen per cent of the propranolol group versus 11% of the control group developed cardiac varices. Recurrent variceal bleeding was encountered in 27% of the propranolol group and 19% of the control group. Three patients in the propranolol group, compared with two patients in the control group, died of massive variceal bleeding. Eighty per cent of them bled from cardiac varices. Both groups had similar survival rates. We therefore concluded that the use of propranolol after variceal obliteration by sclerotherapy can neither prevent oesophagogastric variceal recurrence nor prevent further rebleeding.