FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 309:1539-1542 December 22, 1983 Number 25 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

We conducted a prospective randomized trial of propranolol for the prevention of recurrent variceal bleeding in 48 patients with cirrhosis of the liver. During a follow-up period of up to 21 months, 12 of 26 patients in the propranolol group and 11 of 22 in the control group had rebleeding from esophageal varices. There was no significant difference in rebleeding between the two groups. This contrasts with a previous report of the efficacy of propranolol in preventing recurrent gastrointestinal bleeding in alcoholic cirrhosis. The difference in results may be due to the inclusion in our study of patients with other causes of cirrhosis and more severe liver disease. Propranolol may not be indicated for the prophylaxis of variceal rebleeding in such patients, and we advocate that its use be limited at present to controlled clinical trials.

This article has been cited by other articles:

• Dib, N., Oberti, F., Cales, P. (2006). Current management of the complications of portal hypertension: variceal bleeding and ascites.. CMAJ 174: 1433-1443 [Abstract] [Full Text]  
• Thalheimer, U, Mela, M, Patch, D, Burroughs, A K (2004). Monitoring target reduction in hepatic venous pressure gradient during pharmacological therapy of portal hypertension: a close look at the evidence. Gut 53: 143-148 [Abstract] [Full Text]  
• Sharara, A. I., Rockey, D. C. (2001). Gastroesophageal Variceal Hemorrhage. NEJM 345: 669-681 [Full Text]  
• Gow, P J, Chapman, R W (2001). Modern management of oesophageal varices. Postgrad. Med. J. 77: 75-81 [Abstract] [Full Text]  
• Jalan, R, Hayes, P C (2000). UK guidelines on the management of variceal haemorrhage in cirrhotic patients. Gut 46: iii1-15 [Full Text]  
• Hayes, P C (1996). The coming of age of band ligation for oesophageal varices. BMJ 312: 1111-1112 [Full Text]