Intravariceal versus paravariceal sclerotherapy: a prospective, controlled, randomised trial.

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Abstract
Fifty four consecutive patients with oesophageal variceal bleeding were randomized 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% v 18.7%, 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 significnatly 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.