Is weekly sclerotherapy really better than every three weeks?

To compare the efficacy and safety of one week versus three weeks interval treatment schedules of endoscopic sclerotherapy, injections were carried out in a prospective manner in 96 patients with variceal bleeding; 47 on a one week and 49 on a three week treatment schedule. Weekly endoscopic sclerotherapy eradicated oesophageal varices significantly (p < 0.01) earlier (mean ± SD 7.1 ± 2.43 weeks) as compared with the three week regimen (mean ± SD 14.86 ± 4.86 weeks). The rebleeding rate was also significantly less (p < 0.05) with weekly endoscopic sclerotherapy (8.5%) as compared with three week endoscopic sclerotherapy treatment (26.5%). The amount of alcohol and the number of endoscopic sclerotherapy courses required for complete variceal eradication did not differ significantly between the two groups. Patients undergoing weekly injections were seen to have significantly more oesophageal ulcers (p < 0.01) as compared with the three week group, necessitating at times (23%) postponement of the procedure. There was, however, no difference between the two groups in the frequency of oesophageal structure formation, dysphagia, retrosternal pain, and fever. Mortality was also similar in the two groups. It can be concluded that a weekly schedule of endoscopic sclerotherapy appears superior to a three week schedule.