Fifty four consecutive patients with oesophageal variceal bleeding were randomised to undergo intravariceal (28 patients) or paravariceal (26 patients) sclerotherapy, every three weeks. Intravariceal technique was found significantly (p<0·01) more effective in controlling active variceal bleeding than the paravariceal technique (91% v18·7% respectively). The mean (±SD) time taken for variceal eradication by intravariceal sclerotherapy (15·4±5·3 weeks) was significantly (p<0·001) less than paravariceal (26·8±6·6 weeks) technique. The number of sclerotherapy sessions needed with intravariceal technique were also significantly less. Rebleeding was seen in 38·5% patients after para and 14·3% after intravariceal injections (NS). Except for retrosternal pain, which occurred more often (p<0·01) with paravariceal technique, there was no difference in the incidence of other complications or mortality between the two groups. Variceal recurrence was seen in seven patients (25%) in the intra and one (3·9%) patient in the paravariceal group (p<0·01) after a mean follow up of 29·4±9·1 weeks. Intravariceal sclerotherapy was superior to paravariceal in the control of active variceal bleeding and for total variceal obliteration, but was associated with a higher variceal recurrence.
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