Continuing Somatostatin Does Not Prevent Rebleeding After Variceal Ligation For Acute Variceal Bleeding

Abstract

Background: variceal bleeding (VB) is a medical emergency. Endoscopic variceal ligation (EVL) performed quickly is beneficial. Even
after EVL, somatostatin is still utilized in the VB band for 2–5 days. The advantage of continuing somatostatin after EVL is uncertain
since EVL is the main method for achieving hemostasis.
Aim and objectives: to determine if continuing somatostatin after EVL is effective in reducing mortality and rebleeding.
Subjects and methods: In this study, 75 patients with variceal bleeding were divided into two treatment groups (TG); TG2 & TG5,
which received somatostatin (250 micrograme bolus + a continuous infusion of 500 micrograme/h) for two days and five days,
respectively, and one control group (TG0), which received 0.9 percent normal saline and was monitored for six weeks.
Result: There were a total of 8 rebleeds; they happened more often in the TG0 (4%) and TG2 (2.6%) and TG5 (4%) groups, albeit not
statistically significantly (P=0.751). The treatment group substantially experienced more adverse drug reactions (ADRs) than the control
group (P=0.003). Diarrhoea was the most frequent ADR, followed by hyperglycemia and bradycardia, with 14 patients mentioning two
or more ADR. In comparison to the control group, ADR was considerably greater in the treatment groups. As the days of somatostatin
medication increased, the length of the hospital stay rose considerably (P=0.041).
Conclusion: We conclude that in acute VB, there is no justification for continuing somatostatin after EVL since it had no beneficial
effect on preventing rebleeding and, instead, increased the risk of ADR and length of hospital stay.