Alcoholic versus Nonalcoholic Cirrhosis in a Randomized Controlled Trial of Emergency Treatment of Acutely Bleeding Esophageal Varices

Abstract

Introduction: Alcoholic cirrhosis is the most common cause of bleeding esophageal varices (BEV). Yet, it has been proposed that portal-systemic shunts be avoided in alcoholic cirrhotics because, according to retrospective, unrandomized observations of elective treatment of BEV by portal-systemic shunts, survival rate was significantly lower in alcoholic than in nonalcoholic cirrhotics. We examined this important issue in a randomized controlled trial. Methods: 211 unselected, consecutive patients with cirrhosis and acute BEV were randomized to endoscopic sclerotherapy (EST) (n=106) or emergency portacaval shunt (EPCS) (105).