Prophylactic sclerotherapy of esophageal high bleeding risk varices. A prospective randomized trial, with a long follow-up

The efficacy of prophylactic sclerotherapy of varices at high risk of bleeding in cirrhotic patients with spared clotting function before the first episode of variceal haemorrhage, was evaluated in a prospective, randomized, controlled trial. 37 patients were treated as followed: 18 patients received prophylactic sclerotherapy and 19 served as controls. The median follow-up was 36.6 months. The mortality rate due to bleeding during the overall observation period was significantly lower in the sclerotherapy group versus control group (P = 0.003). Life table curves showed that prophylactic sclerotherapy significantly diminished the incidence of variceal haemorrhage (P = 0.02) and significantly improved overall survival (P = 0.009). We concluded that prophylactic sclerotherapy is useful in the treatment of cirrhotic patients with high-risk bleeding varices and spared clotting function.