Am J Gastroenterol

One-day octreotide regimen may streamline variceal bleed management

October 21, 2025

A 1-day octreotide infusion following endoscopic band ligation is non-inferior to the standard 5-day regimen for preventing early re-bleeding, with no significant differences in longer-term outcomes. Shortening octreotide duration may reduce transfusion needs and hospital stay without compromising efficacy.

Study details: A nationwide, multicenter, open-label, non-inferiority randomized trial in Thailand enrolled 220 cirrhotic patients with acute esophageal variceal bleeding who underwent successful endoscopic band ligation. Participants were randomized to receive either a 1-day (n = 109) or 5-day (n = 111) continuous octreotide infusion post-endoscopy.

Results: Rates of 5-day re-bleeding (1.83% vs. 1.80%), 6-week re-bleeding (8.26% vs. 10.81%), and 6-week all-cause mortality (5.50% vs. 6.31%) were similar between the 1-day and 5-day groups, meeting non-inferiority criteria. The 1-day group required fewer blood transfusions and had shorter times to oral diet and hospital discharge.

Source:

Chirapongsathorn S, et al. (2025, October 15). Am J Gastroenterol. One versus five days of octreotide infusion for acute esophageal variceal bleeding: a randomized controlled trial. https://pubmed.ncbi.nlm.nih.gov/41090987/