Carvedilol and Endoscopic Variceal Ligation for High-Risk Esophageal Varices in Hepatocellular Carcinoma

This study is investigating the best way to prevent bleeding from enlarged veins in the esophagus, known as varices, in patients who have liver cancer and are at high risk for such bleeding. The research focuses on comparing two treatment approaches: using a medication called Carvedilol alone, or combining it with a procedure called endoscopic variceal ligation (EVL). Carvedilol is a type of drug known as a non-selective beta blocker, which can help reduce blood pressure in the veins. The study aims to find out which method is more effective in preventing variceal bleeding, which is a serious complication for patients with liver cancer. Participants in this study are adults between 18 and 80 years old, all of whom have liver cancer and high-risk esophageal varices. They are randomly assigned to one of two groups. One group receives only Carvedilol, starting with a low dose and gradually increasing to the maximum tolerable dose. The other group receives the same Carvedilol treatment along with EVL, a procedure done every three weeks until the varices are removed, and then every three months. Participants are monitored monthly for the first three months and again at the sixth month to assess the effectiveness of the treatments. The study's goal is to determine which approach better prevents bleeding and improves patient outcomes.