{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T10:17:28Z","timestamp":1784801848685,"version":"3.55.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":5875,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100011995","name":"Fundaci\u00f3 Investigaci\u00f3 Sant Pau","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100011995","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1999,8]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Recent trials have shown that somatostatin (SMT) is as effective as sclerotherapy in the treatment of acute variceal bleeding and that the combination of both treatments is more effective than sclerotherapy alone. To assess whether the addition of sclerotherapy improves the efficacy of SMT alone, all patients admitted to our unit with gastrointestinal bleeding and with suspected cirrhosis received a continuous infusion of SMT (250 \u03bcg\/h). Endoscopy was performed between 1 and 5 hours later, and patients with esophageal variceal bleeding were randomized to receive or not to receive sclerotherapy. In both groups, SMT infusion was continued for 5 days. Fifty patient admissions were allocated to each group. Therapeutic failure occurred in 21 cases of the SMT group and in 7 cases of the combined-therapy group (<jats:italic toggle=\"yes\">P<\/jats:italic> = .002). Failure to control the acute episode occurred in 24% vs. 8% (<jats:italic toggle=\"yes\">P<\/jats:italic> = .03) and early rebleeding in 24% vs. 7% (<jats:italic toggle=\"yes\">P<\/jats:italic> = .03), respectively. Transfusional requirements were significantly higher in the SMT group, while the incidence of complications was lower (8% vs. 24%; <jats:italic toggle=\"yes\">P<\/jats:italic> = .029). In the multivariate analysis, the presence of shock at admission and active bleeding during endoscopy were the variables that better predicted the failure of therapy with SMT alone. Mortality at 6 weeks was similar. These data demonstrate that the addition of sclerotherapy significantly improves the efficacy of SMT alone for the treatment of acute variceal bleeding, although it also increases the rate of complications. Patients with shock and those with active bleeding are more likely to benefit from this combined therapy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.510300222","type":"journal-article","created":{"date-parts":[[2004,7,28]],"date-time":"2004-07-28T07:26:28Z","timestamp":1090999588000},"page":"384-389","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":85,"title":["Somatostatin alone or combined with emergency sclerotherapy in the treatment of acute esophageal variceal bleeding: A prospective randomized trial"],"prefix":"10.1097","volume":"30","author":[{"given":"C\u00e0ndid","family":"Villanueva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Ortiz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"S\u00e0bat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adolfo","family":"Gallego","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Torras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"German","family":"Soriano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"S\u00e1inz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaume","family":"Boadas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Cuss\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Guarner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquim","family":"Balanz\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"10.1002\/hep.510300222-BIB1|cit1","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1002\/hep.1840220145","article-title":"The treatment of portal hypertension: a meta-analytic review","volume":"22","author":"D'Amico","year":"1995","journal-title":"Hepatology"},{"key":"10.1002\/hep.510300222-BIB2|cit2","first-page":"71","article-title":"Therapeutic controversies and randomised controlled trials: prevention of bleeding and rebleeding in cirrhosis","volume":"2","author":"Pagliaro","year":"1989","journal-title":"Gastroenterol Int"},{"key":"10.1002\/hep.510300222-BIB3|cit3","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/0950-3528(92)90033-B","article-title":"Emergency and elective endoscopic therapy for variceal hemorrhage","volume":"6","author":"Westaby","year":"1992","journal-title":"Bailli\u00e8res Clin Gastroenterol"},{"key":"10.1002\/hep.510300222-BIB4|cit4","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/0016-5085(81)90014-7","article-title":"Effects of somatostatin on hepatic and systemic hemodynamics in patients with cirrhosis of the liver. 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