Octreótido, tratamiento endoscópico o ambos en la hemorragia variceal activa en pacientes cirróticos: estudio multicéntricovariceal bleeding: a multicentric study
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2004-03Metadata
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Silva P., Guillermo
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Octreótido, tratamiento endoscópico o ambos en la hemorragia variceal activa en pacientes cirróticos: estudio multicéntricovariceal bleeding: a multicentric study
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Abstract
Acute variceal bleeding in cirrhotic patients is an
emergency with a high risk of rebleeding and death. Endoscopic procedures such as sclerotherapy
or banding, combined or not with drugs such as octreotide could be considered. Aim: To assess
the value of octreotide in the control of acute variceal bleeding. Patients and methods: Ninetytwo
patients were randomized into three groups: endoscopic therapy plus octreotide 50 μg/h bolus
and continuous infusion for 5 days (n= 36); octreotide (same dosage) (n= 13) and endoscopic
therapy only (banding and/or sclerotherapy) (n= 43). Results: Haemostasis at 24 hours was
achieved in 97% of patients with combined treatment, 69% of patients receiving octreotide, and
93% of patients with endoscopic therapy (p= 0.2). Three patients with combined treatment, four
patients receiving octreotide and eight patients with endoscopic therapy, rebled during the first
five days (p= 0.15). The mean of blood units transfused was similar in the three groups. No
differences were observed in hospital days and side effects. At 42 days of follow up, eight patients
with endoscopic therapy, one patients with combined therapy and 2 patients receiving octreotide,
died (p=NS). Conclusions: Octreotide is useful in the management of acute variceal bleeding.
The absence of important side effects, renders it as a safe adjuvant treatment associated with
endoscopic treatment
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REVISTA MEDICA DE CHILE, V.: 132, issue: 3, p.: 285-294, MAR 2004.
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