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).

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