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KMID : 1103920060120030373
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Korean Journal of Hepatology
2006 Volume.12 No. 3 p.373 ~ p.384
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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
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Seo Yeon Seok
Um Soon-Ho
Hyun Jong-Jin
Kim Youn Ho
Park Sang-Hoon
Keum Bo-Ra
Kim Yong-Sik
Jean Yoon-Tae
Lee Hong-Sik
Chun Hoon-Jai
Lee Sang-Woo
Choi Jai-Hyun
Kim Chang-Duck
Ryu Ho-Sang
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Abstract
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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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KEYWORD
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Liver cirrhosis, Variceal bleeding, Hemostasis, Terlipressin, Somatostatin
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