Elective Sclerotherapy - Technique and Results

Elective sclerotherapy, to obliterate oesophageal varices, is discussed with particular reference to the results of three controlled trials. There is strong support from each of these studies for the prevention of rebleeding. However, the results for overall survival are conflicting. This discrepancy is discussed in relationship to major differences in trial design. Different techniques of injection sclerotherapy are reviewed, although there is a paucity of comparative data. A prospective study is reported in which 147 patients were followed after initial obliteration of varices, in order to document the rate of recurrence of varices, the associated rate of rebleeding and hence the need for, and timing of, follow-up endoscopy.