Abstract
Esophageal variceal bleeding is a medical emergency that carries a high mortality rate despite appropriate management. Terlipressin and Octreotide are two common agents used as adjuvant agents in the management of variceal bleeding. The objective of this study is to compare the effectiveness of Terlipressin with Octreotide along with endoscopic band ligation in the management of esophageal variceal bleeding in cirrhotic patients. This randomized control study was carried out at the Department of General Medicine, Fatima Memorial Hospital, Lahore, for six months extending from February 2019 to July 2019. A total of 100 cirrhotic patients were selected /based on predetermined inclusion and exclusion criteria. The patients were randomly divided into two groups of equal strength. Hence, 50 patients were included in Group A and 50 patients were included in Group B along with banding. Group A received Terlipressin whereas Group B received Octreotide. The two groups were monitored for variceal bleeding for 72 hours. The mean age of the patients in Group A was 55.9±7.3 years and for the patients in Group B it was 56.8±7.4 years. In Group A, 36 (72.0%) male and 14 (28.0%) female patients were included. In Group B, there were 34 (68.0%) male and 16 (32.0%) female patients. In Group A, the treatment was effective for 46 (92.0%) patients and in Group B, 36 (72.0%) patients had an effective treatment. It is concluded from this study that Terlipressin is statistically more effective than Octerotide in terms of preventing esophageal variceal bleeding.
Highlights
Cirrhosis of liver is a combination of irreversible hepatic fibrosis and regenerative nodules formation due to constant hepatic injury
The aim of this article is to compare the effectiveness of Terlipressin and Octreotide along with endoscopic band ligation in the management of esophageal variceal bleeding in cirrhotic patients
Terlipressin and Octreotide are two common agents used as adjuvant agents in the management of variceal bleeding
Summary
Cirrhosis of liver is a combination of irreversible hepatic fibrosis and regenerative nodules formation due to constant hepatic injury. The most common cause of this injury worldwide is alcohol but hepatitis B and C are major causes in the third world countries. The symptoms of liver cirrhosis range from being asymptomatic to jaundice, infertility, loss of hair, and pulmonary hypertension depending on the extent of the liver injury [1, 2]. The disturbed architecture of liver due to fibrosis leads to increased vascular resistance, hyperdynamic circulation, and splanchic vasodilation, causing the local complication of portal hypertension. Portal hypertension causes gastropathy and esophageal varices [1, 3]. Other complications due to hepatocellular failure include ascites, edema, hepatorenal syndrome, hepatic encephalopathy and hepatopulmonary syndrome [4]
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