For the secondary prevention of variceal bleeding in patients with cirrhosis, drug therapy is as effective as endoscopic banding, results of a controlled trial indicate.
Until now, endoscopic variceal banding had not been compared with hepatic venous pressure-guided medical therapy, Dr. Andrew K. Burroughs of the Royal Free Hospital NHS Trust in London and colleagues note in the October issue of the journal Gastroenterology.
They randomized 102 “well-matched” cirrhotic patients with a recent esophageal variceal bleed to either endoscopic banding or beta-blocker and nitrate therapy. They measured hepatic venous pressure gradient at baseline and at 3 months in drug-treated subjects and yearly in all patients.
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