Forty-five cirrhotic patients with oesophageal
varices underwent endoscopic injection
sclerotherapy in a prospective randomized trial carried out to compare two
sclerosing agents (5 per cent
ethanolamine oleate and 2 per cent
sodium tetradecyl sulphate (STD] with respect to safety, efficacy and complications. Twenty-three patients were allocated to the
ethanolamine group and twenty-two to the STD group. The rate of control of acute
bleeding was 100 per cent (6/6) in the
ethanolamine group and 75 per cent (3/4) in the STD group. There was a significantly lower rate of postinjection
bleeding after the over-tube was removed at the initial session of
sclerotherapy when
ethanolamine was injected 0/23 versus 7/22, 32 per cent; P less than 0.01) and at the second session there was a significantly (P less than 0.01) higher rate of jet-like
bleeding from injection sites in the STD group (6/21, 29 per cent) than in the
ethanolamine group (0/22). The disappearance rate of red colour signs 1 week after the initial session of
sclerotherapy in the
ethanolamine group was 100 per cent and 62 per cent in the STD group. Early oesophageal
ulcers developed less frequently in the
ethanolamine group (0 and 9 per cent) than in the STD group (24 per cent and 43 per cent both after the initial (P less than 0.05) and the second session of
sclerotherapy (P less than 0.01]. Early
bleeding from an oesophageal
ulcer occurred only in the STD group (5/21, 24 per cent) before the third session of
sclerotherapy (P less than 0.05). The rate of early mortality did not differ between the two groups. We conclude that
ethanolamine seems to be safer and more efficacious than STD for sclerosing oesophageal
varices.