Veno-occlusive procedures for Control of Bleeding Oesophageal Varices Sclerotherapy Versus Surgery
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This study was carried out on 78 patients (68 males and 10 females) who had bleeding oesophageal varices. The aim of the study was to compare between sclerotherapy and the surgery of splenectomy and devascularization in the management of bleeding oesophageal varices. All the patients after resuscitation and clinical examination had full laboratory investigations, abdominal ultrasonography then upper gastro-intestinal endoscopy. Patients with Modified Child's A and B classification were randomly allocated into two groups: group I including patients managed by sclero therapy and group II including patients subjected to surgery. Bleeding was controlled in both groups with insignificant statistical dfference, but complete eradication of the varices was achieved in 86.3% in group I and in 32.3% in group Il which was statistically significant Rebleeding occurred in 13.6% and 17.6%, ascites in 18% and 11.8%, encephalopathy in 4.5% and 5.9% and mortality in 15.6% and 20.6% for both groups respectively. These results were statistically insignificant Liver biopsy was performed in 82% of the all patients and denoted that bilharzial fibrosis with cirrhotic liver is the commonest etiological factor (71.8%). . It is considered that sclerotherapy is a good modality for managing bleeding oesophageal varices and also for preventing rebleeding.