Objective: To compare the portal hemodynamic effects of different doses of somatostatin analogue octreotide (sandostatin) with beta-blocker (propranolol) on prevention of early variceal re-bleeding in patients with cirrhotic portal hypertension.
Methods: Thirty patients of cirrhosis with moderate to severe esophageal varices were randomly allocated into three groups. 10 patients in group A were given propranolol 10-20 mg orally three times a day for 7 days; 10 patients in group B were administrated octreotide 0.05 mg subcutaneously two times a day for 3 days, while 10 patients in group C received octreotide 0.1 mg subcutaneously two times a day for 3 days. The postprandial vessel diameter, maximal and average flow velocity (Vmax/V) and flow volume of portal vein (PV), splenic vein (SV) and superior mesenteric vein (SMV) were measured before and after therapy by using Echo-Doppler technology.
Results: There was a trend of decrease of the vessel diameter in all the three groups, but with no significant difference. However, the average velocity and flow volume of PV were significantly diminished in the propranolol group (P < 0.05), while there was no statistical change of them in SV and SMV groups. In octreotide 0.05 mg and 0.1 mg group, the average velocity and flow volume of PV, SV and SMV were significantly decreased (P > 0.05). Besides, octreotide 0.1 mg group but not 0.05 mg group was more active in decreasing flow volume of PV as compared with the propranolol group, while both octreotide groups were superior to the propranolol group in decreasing flow volume of SV and SMV.
Conclusions: Octreotide may have potential prophylactic effect in prevention of early variceal re-bleeding in cirrhotic patients with portal hypertension.