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A prospective study comparing the efficacy of early administration of terlipressin and somatostatin for the control of acute variceal bleeding in patients with cirrhosis

Authors
Seo Y.S.Um S.H.Hyun J.J.Kim Y.H.Park S.Keum B.R.Kim Y.S.Jeen Y.T.Lee H.S.Chun H.J.Lee S.W.Choi J.H.Kim C.D.Ryu H.S.
Issue Date
Sep-2006
Keywords
간경변증; 정맥류 출혈; 지혈; Liver cirrhosis; Variceal bleeding; Hemostasis; Terlipressin; Somatostatin
Citation
The Korean journal of hepatology, v.12, no.3, pp.373 - 384
Indexed
SCOPUS
KCI
OTHER
Journal Title
The Korean journal of hepatology
Volume
12
Number
3
Start Page
373
End Page
384
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/19250
ISSN
1738-222X
Abstract
BACKGROUND/AIMS: Terlipressin and somatostatin decrease portal venous pressure and they are used for the treatment of variceal bleeding. However, only a few studies have compared the efficacy of these drugs in combination with other procedures for hemostasis. Therefore, we performed a prospective study to compare the efficacy of terlipressin and somatostatin for controlling acute variceal bleeding when used in combination with other procedures for hemostasis. METHODS: A total of 98 patients, who presented with variceal bleeding from September 2003 to May 2005, were randomly divided into the somatostatin group or terlipressin group. We compared the 5-day failure rate (defined as failure to control bleeding, rebleeding or death within 5 days of admission) and the 6-week mortality. The prognostic factors for 5-day failure and 6-week mortality were also evaluated. RESULTS: There were no differences in baseline characteristics between the two groups. The overall 5-day failure rate and the cumulative 6-week mortality were 16.3% and 15.8%, respectively. The five-day failure rate and the cumulative 6-week mortality were not significantly different between the somatostatin and terlipressin groups. Hepatocellular carcinoma, the baseline serum creatinine level and endoscopic treatment for hemostasis were the significant predictors of 5-day failure; the baseline serum creatinine level was the predictor of 6-week mortality. CONCLUSIONS: Both somatostatin and terlipressin were effective and showed comparable efficacy for the control of the acute variceal bleeding in the setting of a combined therapeutic approach. The baseline serum creatinine level may be a significant predictor for patient failure at 5 days and the 6-week mortality.
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Seo, Yeon Seok
Anam Hospital (Department of Gastroenterology and Hepatology, Anam Hospital)
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