ABSTRACT
This chapter discusses the hemodynamic effects, efficacy, and complications of the two more widely used splanchnic vasoconstrictors: vasopressin and somatostatin and its derivatives, in the treatment of variceal bleeding in patients with portal hypertension. In the trial by Walker et al. it is impossible to assess the efficacy of glypressin because of the concomitant use of the Sengstaken-Blakemore tube in about 80% of the patients. However, the use of somatostatin in the treatment of acute variceal bleeding in cirrhotic patients has been assessed in two published controlled randomized trials, both comparing the effectiveness and complications of somatostatin and vasopressin intravenous infusions. During the past few years, several efforts had been made in an attempt to develop new somatostatin analogues with major specificity and longer half-life than the normal tetradecapeptide currently used. Gastrointestinal bleeding from ruptured esophageal varices is one of the main complications of portal hypertension.
