Efficacy and Safety of Endoscopic Injection of Fibrin Sealant Versus Endoscopic Ligature for Bleeding Esophageal Varices

Inclusion Criteria: Included in the study were patients with proven bleeding from esophageal varices due to liver cirrhosis: * with a minimum age of 18 years, * with bleeding symptoms (hematemesis, melena, hematochezia, hypotension, tachycardia) that had lasted not longer than 48 hours prior to hospital admission, * who were expected to be hospitalized for at least seven days, * who agreed to participate in the study. Randomization did not take place if another therapy was medically indicated for any reason. Exclusion Criteria: Patients were excluded from the study: * in whom introduction of an endoscope was not possible for technical reasons, * who had received an alternative endoscopic treatment to eradicate varices during the last three months (sclerotherapy, ligation), * who had proven additional fundus bleeding from varices or bleeding from a hypertensive gastropathy, * who had end stage tumor disease or end stage liver cirrhosis (Child Pugh class C with organ complications, such as hepatonephric syndrome, infected ascites etc.), * who were pregnant or breast feeding, * who had a known pulmonary disease combined with restricted lung function or right ventricular failure, * who had congenital or acquired coagulopathies of non-hepatic origin, * who were currently participating or had participated in another study during the past 30 days or had already been included in this study once, * who were treated with drugs to decrease portal vein pressure (somatostatin, somatostatin analogs, terlipressin, glycylpressin, except β-blockers and nitrates), * who had shown an allergic reaction to thrombin or aprotinin, * who had a heparin-induced thrombocytopenia Type I or Type II.