Eleven-year survey of safety and efficacy of endoscopic injection sclerotherapy using 2% sodium tetradecyl sulfate and contrast medium

We conducted a retrospective 11-year survey to evaluate the post-treatment course in 285 patients with esophagogastric varices following administration of endoscopic injection sclerotherapy as an emergency, elective, or prophylactic procedure using freshly prepared 2% sodium tetradecyl sulfate not containing benzyl alcohol. These agents were injected into the varices and the supplying veins under fluoroscopic observation, usually in a single treatment. In all patients the variceal size was greatly reduced following one treatment. The amount of sclerosant necessary to fill the varices and the supplying veins varied widely among the patients. Acute variceal bleeding was controlled in 80 (96.4%) of the 83 patients, and the risk of rebleeding during the first month was 0.0548 in the emergency procedures. The serious complication of perforation was observed in one patient. The cause of death was established in the 122 patients who died and included esophageal variceal bleeding in eight (6.6%) and gastric variceal bleeding in one (0.8%). The overall 50% survival period was 5 years and 4 months. Multivariate analysis disclosed that the factors with the greatest negative effect on survival were poor hepatic status and the presence of hepatocellular carcinoma. The method of preparation and the procedure itself may be considered safe and effective in the treatment of esophagogastric varices.