Banding Versus Propranolol for Primary Prophylaxis of Variceal Bleeding

Randomized Study Comparing Ligation With Propranolol for Primary Prophylaxis of Variceal Bleeding in Candidates for Liver Transplantation

Whether beta-blockers or banding is the best therapy for primary prophylaxis of variceal bleeding is subject to debate. A randomized comparison between the two treatments was performed in candidates for liver transplantation. Patients with Child B and C cirrhosis with high risk varices and no previous variceal bleeding are randomized to propranolol or variceal bleeding. Primary end point is variceal bleeding

Inclusion Criteria:

• liver cirrhosis
• child pugh>=B7
• studied for transplantation
• age between 18 an 65 ys
• no previous bleeding from varices
• signed informed consent

Exclusion Criteria:

• esophageal varices less than F2 blue
• gastric varices
• previous variceal surgical or radiological or endoscopical treatment
• hepatocarcinoma
• portal vein thrombosis
• severe heart, respiratory or renal failure
• contraindications to betablockers
• treatment with nitrates, calcium antagonist or anti-arhythmic drugs that can not be suspended
• Pregnancy
• neoplasias
• non cooperation