Clinical outcomes of gastric variceal obliteration using N-butyl-2-cyanoacrylate in patients with acute gastric variceal hemorrhage.
- Author:
Chung Hwan JUN
1
;
Ka Rham KIM
;
Jae Hyun YOON
;
Han Ra KOH
;
Won Suk CHOI
;
Kyu Man CHO
;
Sung Uk LIM
;
Chang Hwan PARK
;
Young Eun JOO
;
Hyun Soo KIM
;
Sung Kyu CHOI
;
Jong Sun REW
Author Information
1. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. estevanj@naver.com
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Esophageal and gastric varices;
Cyanoacrylates;
Hemostasis;
Endoscopy;
Treatment outcome
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Enbucrilate/adverse effects/*therapeutic use;
Endoscopy, Gastrointestinal;
Esophageal and Gastric Varices/complications/diagnosis/mortality/*therapy;
Female;
Gastrointestinal Hemorrhage/diagnosis/etiology/mortality/*therapy;
*Hemostatic Techniques/adverse effects/mortality;
Humans;
Male;
Middle Aged;
Recurrence;
Retrospective Studies;
Time Factors;
Treatment Outcome;
Young Adult
- From:The Korean Journal of Internal Medicine
2014;29(4):437-444
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: To evaluate the long-term efficacy and safety of endoscopic injection of N-butyl-2-cyanoacrylate (NBC; Histoacryl) for treatment of bleeding gastric varices. METHODS: We retrospectively analyzed the records of 455 patients with gastric variceal hemorrhage (GVH) who were consecutively treated with NBC from January 2004 to July 2013, with a mean follow-up period of 582 days. The patients' endoscopic findings, initial hemostasis, complications, rebleeding rates, and bleeding-related death rates were reviewed. RESULTS: Hemostasis was achieved initially in 96.9% (441/455) of patients; rebleeding occurred in 35.2% (160/455), and the bleeding-related death rate was 6.8% (31/455) during follow-up. Complications included fever (6.8%), abdominal pain (3.7%), diarrhea (1.3%), spontaneous bacterial peritonitis (0.7%), bacteremia (0.4%), and embolism (0.2%). A red-color sign on concomitant esophageal varices (EVs) (p = 0.002) and previous history of variceal bleeding (p < 0.001) were significant risk factors for rebleeding within 1 year. The Child-Pugh score (p < 0.001), presence of hepatocellular carcinoma (p = 0.001), and failure of initial hemostasis (p < 0.001) were the risk factors most closely associated with bleeding-related death. CONCLUSIONS: This study provides a comprehensive overview of the outcomes and prognostic factors of patients with GVH. The results may help in the selection of effective treatment strategies for patients with GVH.
