Long-term follow-up for prophylaxis of esophageal variceal bleeding in patients with hepatic cirrhosis after endoscopic variceal ligation

Objective To investigate the esophageal variceal bleeding,mortality,degree of varices and changes of liver function in patients with hepatic cirrhosis Who underwent endoscopic varieeal ligation (EVL) or received propranolol therapy.Methods One hundred and eighteen patients received either EVL (n=66) or propranolol therapy(n=52).The patients in EVL group were treated with EVL for several times untill varicose vein disappeared.However,the patients in propranolol group received 10 mg of propranolol twice daily at the beginning of treatment.and it was increased to maximum tolerated dose gradually.All patients were followed up for 20 months.The bleeding rate, mortality,improvement of varicose vein and changes of hepatic function before and after treatment were compared between two groups.Results Among 58 patients in EVL group,bleeding was found in 7(12.1%) patients,and 2(3.4%) patients died.Whereas in propranolol group bleeding was found in14(30.4%) of 46 patients and 6(13%) patients died.There was significant difference between EVL group and propranolol group (P 0.05).Conclusions Compared with propranolol therapy,EVL has advantages in decreasing bleeding and mortality as wellas improving the degree of varicose vein without liver damage. Key words: Esophageal varices Prevention; Endoscopic varices ligation; Propranolol