Injection sclerotherapy for the long‐term management of variceal bleeding

Abstract

AbstractInjection sclerotherapy for the long‐term management of variceal bleeding is discussed with particular reference to our experience at King's College Hospital. The important questions of which techniques to use, which sclerosing agent to inject, the timing of the first and subsequent treatments, and the periods between follow‐up endoscopic examinations are reviewed. The efficacy of sclerotherapy both with respect to rebleeding and survival are assessed on the basis of 2 completed controlled trials and a third study from which preliminary data are available. A possible role for the prophylatic use of sclerotherapy in selected high‐risk patients is discussed. The complications associated with sclerotherpy are detailed and attention is drawn to the very low mortality rate of the procedure.