Randomized study comparing banding and propranolol to prevent initial variceal haemorrhage in cirrhotics with high-risk esophageal varices

This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Prophylactic banding seems to be a more promising therapy than propranolol for the prevention of initial variceal bleeding in compliant patients who are at high risk of initial variceal haemorrhage and who are candidates for liver transplantation. The propranolol group had significantly higher treatment failures and, arithmetically, more frequent adverse events requiring the discontinuation of therapy. The direct costs of the propranolol group were not significantly less than those for banding.