PATIENTS AND METHODS: RESULTS: This study proved the value of the combined
therapy for the initial control of all bleeders (the follow-up period ranged from 12 to 32 months). In the
sclerosis group, failure of the initial control of
bleeding was reported in two cases (3.6%). Recurrent
bleeding occurred in 8.6% in the combined therapy group compared to 25% in the
sclerosis group (p < 0.01). Two months of
therapy was required to achieve complete eradication of
varices in 56.5% and 21.4% in the combined
therapy and the
sclerosis group, respectively. The mean number of sessions needed until the time of evaluation was 2.4 +/- 1.1 in the combined therapy group versus 5.1 +/- 2.3 sessions in the
sclerosis group. The difference showed high statistical significance (p < 0.01). Minor complications occurred less frequently in the combined therapy group. Only one patient in the combined therapy group developed portal
pyemia after extension of the
tissue adhesive material from the site of injection into the portal vein. This patient died of
hepatic failure. The mortality in the combined therapy group was lower than that in the
sclerosis group (3.5% and 8.8% respectively, p > 0.05).
CONCLUSION: The combined use of
tissue adhesive and
sclerosant materials seems to be the best plan for rapid eradication of esophagogastric
varices within a short time, requiring the lowest number of injection sessions and involving minor complications and low mortality.