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Abstract Summary and conclusion Bleeding from esophageal varices is one of the major health problems in the world especially in Egypt where schisiosorniasis and hepatitis arc prevelant, This study aimed at comparing the efficacy and safety of EVL versus the combination of EVL plus Propronolol and diuretics (Spironolactonc and Burnctanidc) or the combination of EVL plus Lisinopril in the prevention of esophageal variceal rebleeding. This study was carried out on selected one hundred and fifty cirrhotic patients with a history of previous esophageal variceal bleeding. They were randomly allocated to EVL (Group l? n=50) or EVL plus Propranolol and diuretics (Spironolactone and Bumctanidc) (Gp II, n=50) or EVL plus Lisinopril (Gp III, n=5Q). LVL was done at 2-4wk intervaj with the intention lo eradicale varices. In Or II, incremental dosage of Propranolol (sufficient to reduce heart rate to 55 beats/min or 25% reduction from baseline) was administered and continued after obliteration of varices. Spironolactone was given at a dose of IQOmg/day in ascetic patient and 25 mg/day in non ascitic patient. Bumeianide was given at a dose of 1 mg/day in ascetic patient and 0.5 mg day after day in non ascetic patient. In group IE], Lisinopril was given in a dose of 5 mg/day. The cndpointsof the study were obliteration of varices or prevention of rebleeding for six months or death of patient. The three groups of patients had comparable baseline characteristics; all cases were Child grade A and ft. Patients with advanced liver cirrhosis (Child C), patients underwent surgery for portal hypertension, patients taking drugs for primary 95 Summary Summary and conclusion Bleeding from esophageal varices is one of the major health problems in the world especially in Egypt where schisiosorniasis and hepatitis arc prevelant, This study aimed at comparing the efficacy and safety of EVL versus the combination of EVL plus Propronolol and diuretics (Spironolactonc and Burnctanidc) or the combination of EVL plus Lisinopril |