COMPARISON OF ENDOSCOPIC BAND LIGATION ALONE VERSUS PROPANALOL PLUS ENDOSCOPIC BAND LIGATION FOR CONTROL OF REBLEEDING OESOPHAGEAL VARICES IN PATIENTS WITH PORTAL HYPERTENSION

Authors

  • Shahzad Latif Gastroenterology Department, Akhtar Saeed Medical and Dental College, Bahria Town, Lahore.
  • Hafiza Qaria Bushra Saleem Anesthesia Department, Lahore Children Hospital, Lahore.
  • Noureen Akhtar Gynae & Obs. Department, Allama Iqbal Medical Lahore/ Jinnah Hospital Lahore.
  • Rehan Shafique Department of Medicine, Akhtar Saeed Medical and Dental College, Bahria Town Lahore.
  • Anum Pari Department of Medicine, Akhtar Saeed Medical and Dental College, Bahria Town Lahore.
  • Muhammad Naseeb Department of Medicine, Akhtar Saeed Medical and Dental College, Bahria Town Lahore.
  • Tariq Waseem Department of Medicine, Akhtar Saeed Medical and Dental College, Bahria Town Lahore.
  • Iram Manzoor Community Medicine Department, Akhtar Saeed Medical and Dental College, Bahria Town Lahore.

DOI:

https://doi.org/10.33279/jkcd.v11i02.144

Keywords:

Oesophageal Varices, Endoscopic band ligation, Propanalol

Abstract

Objective:

To compare oesophageal varices band ligation alone versus the combination of beta blocker (Propranolol) plus band ligation.

Materials and Methods:

A randomized control trial was carried out in 150 patients who presented with upper GI bleeding as a complication of cirrhosis of liver. After hemodynamic stabilization in the hospital with pharmacological options and/or band ligation procedures through endoscopy, the patients were randomly distributed in two separate groups at discharge from hospital. Group A had endoscopic band ligation every 4 weeks till obliteration of varices and group B were assigned in a group with both beta blocker and band ligation every 4 weeks. Patients were followed monthly for re-bleeding and other complications for six months.

Results:

Ascites was observed in 103 (68.66%) patients and 11.3% had hepatic encephalopathy. High grade oesophageal varices was observed in 111 (74%),26 (17.3%) patients had moderate grade varices, while 13 (8.6%) also had fundal varices. Band ligation was done in all the patients. Patients were randomly distributed in Group A and group B having included 76 and 74 patients respectively through the random table. Seven (4.6 %) patients were lost to follow up. Re-bleeding occurred in 19 (12.66%) after 6 months. A total of 35 (23.3 %) died after 6 months but only one death was attributed to re-bleeding. Re-bleeding occurred in 19 (25%) patients in Group A and none in Group B (p = 0.00). Eleven (14.5%) patients in Group A and 8 patients in group B (10.8%) expired due to complications other than          re-bleeding. A significant difference was observed in rebleeding pattern of two groups where more re-bleeding was noted in group A as compared to group B (p =0.02).

Conclusion:

Endoscopic band ligation plus pharmacological treatment (Propranolol) significantly reduces re-bleeding in patients with oesophageal variceal bleed as compared to band ligation alone.

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Published

2021-06-30

How to Cite

Shahzad Latif, Hafiza Qaria Bushra Saleem, Noureen Akhtar, Rehan Shafique, Anum Pari, Muhammad Naseeb, Tariq Waseem, & Iram Manzoor. (2021). COMPARISON OF ENDOSCOPIC BAND LIGATION ALONE VERSUS PROPANALOL PLUS ENDOSCOPIC BAND LIGATION FOR CONTROL OF REBLEEDING OESOPHAGEAL VARICES IN PATIENTS WITH PORTAL HYPERTENSION. JOURNAL OF KHYBER COLLEGE OF DENTISTRY, 11(02), 32–37. https://doi.org/10.33279/jkcd.v11i02.144

Issue

Vol. 11 No. 02 (2021): Journal of Khyber College of Dentistry

Section

Original Article

License

Copyright (c) 2021 Shahzad Latif, Hafiza Qaria Bushra Saleem, Noureen Akhtar, Rehan Shafique, Anum Pari, Muhammad Naseeb , Tariq Waseem, Iram Manzoor

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