Original Article: PDF OnlyEmergency Endoscopic Variceal Ligation versus Somatostatin for Acute Esophageal Variceal BleedingChen, Wen-Chia, b; Lo, Gin-Hoa, b, *; Tsai, Wei-Luna; Hsu, Ping-Ia, b; Lin, Chiun-Kua, b; Lai, Kwok-Hunga, bAuthor Information aDivision of Gastroenterology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taipei, Taiwan, R.O.C. bNational Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C. *Correspondence to: Dr. Gin-Ho Lo, Division of Gastroenterology, Department of Medicine, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan, R.O.C. E-mail: [email protected] Received: May 16, 2005; • Accepted: December 26, 2005. Journal of the Chinese Medical Association: February 2006 - Volume 69 - Issue 2 - p 60-67 doi: 10.1016/S1726-4901(09)70115-7 Metrics Abstract Background: Endoscopic variceal ligation and somatostatin are widely used for treating acute esophageal variceal bleeding. This study compared the efficacy, safety, and survival of both therapies. Methods: Acute esophageal variceal bleeding patients were randomized to undergo emergency ligation or receive a bolus of 250 μg somatostatin plus infusion at 250 μg/hour for 48 hours and undergo ligation subsequently. Results: Three (4.8%) of 62 patients in the ligation group and 20 (31.7%) of 63 patients in the somatostatin group encountered treatment failure (p = 0.0001). Transfusion requirements were 4.7 ± 3.2 units in the ligation group and 6.9 ± 7.3 units in the somatostatin group (p = 0.03). Hospital stay was 7.7 ± 4.0 days in the ligation group and 10.2 ± 9.9 days in the somatostatin group (p = 0.07). Adverse effects occurred in the ligation group (20 episodes) and the somatostatin group (27 episodes) (p = 0.2). The 42-day mortality rates were 5 patients (8.1%) in the ligation group and 3 patients (4.8%) in the somatostatin group (p = 0.5). Conclusion: Emergency ligation was superior to somatostatin in treating acute esophageal variceal bleeding, with fewer requirements of transfusion and a tendency toward shorter hospital stay. The adverse effects and 42-day mortality rates were similar between both treatments. © 2006 by Lippincott Williams & Wilkins, Inc.