Abstract

Objective: To compare variceal bleed in patients of liver cirrhosis receiving carvedilol versus esophageal band ligation as primary prophylaxis within three months of treatment.
Methodology: This randomized controlled trial was carried out at Department of Medicine, District Head Quarter Hospital, Rawalpindi from September 1st 2016 to February 28th 2017 with 254 patients of cirrhosis with esophageal varices. They were divided into 2 groups with 127 each: Carvedilol group and endoscopic band ligation. Data were recorded at baseline and at regular follow ups for three months or first variceal bleed. Data analysis was performed with SPSS 20. Effect modifiers and confounders were controlled through stratification and Chi Square test applied with p≤0.05 significant.
Results: Out of 254 patients, 188 (74.0%) were male and 66 (26.0%) females. Mean age was 55.60+9.01 years. Mean Child Pugh Score was 6.59+4.09. Frequency of variceal bleeding in patients receiving carvedilol was 35 (27.6%) compared to 27 (21.3%) of esophageal band ligation as primary prophylaxis within three months of treatment.
Conclusion: Variceal bleeding in liver cirrhosis patients taking carvedilol had no significant difference as opposed to esophageal band ligation and both regimens can be used for primary prophylaxis. Carvedilol is helpful in reduction of unnecessary endoscopy related expenditure and discomfort.

Key words: Carvedilol, endoscopic band ligation, cirrhosis, esophageal varies.