Alcoholic versus nonalcoholic @entity82 in a randomized controlled trial of emergency therapy of XXXX varices.

@entity1 @entity82 @entity75 @entity548
BACKGROUND: It has been proposed that portal-systemic shunts be avoided in alcoholic cirrhotics because survival rate is allegedly lower in alcoholics than in nonalcoholics. We examined this issue in a randomized controlled trial. METHODS: Two hundred eleven unselected, consecutive @entity1 with @entity82 and @entity548 esophageal varices were randomized to endoscopic sclerotherapy (EST) (n = 106) or emergency portacaval shunt (EPCS) (105). Treatment was initiated within 8 h. EST failure was treated by rescue portacaval shunt (PCS). Ten-year follow-up was 96%. RESULTS: Results strongly favored EPCS over EST (P  < 0.001). Among EPCS @entity1 , 83% were alcoholic and 17% nonalcoholic. Outcomes were (1) permanent control of @entity548 100% versus 100%; (2) 5-y survival 71% versus 78%; (3) @entity75 14% versus 19%; (4) yearly charges  38,300 versus  43,000. CONCLUSIONS: EPCS results were similar in alcoholic and nonalcoholic cirrhotics. EPCS is an effective first line emergency treatment in all forms of @entity82 , including alcoholic.
