Clinical effect of endoscopic application of tissue adhesive and ligation in treatment of esophagogastric variceal bleeding in children: An analysis of 16 cases
10.3969/j.issn.1001-5256.2018.09.019
- VernacularTitle:内镜下应用组织胶和套扎术治疗儿童食管胃静脉曲张出血16例临床观察
- Author:
Yiqiu PENG
1
;
Yongjun WANG
Author Information
1. Department of Gastroenterology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China
- Publication Type:Research Article
- Keywords:
esophageal and gastric varices;
gastroscopy;
therapeutics;
child
- From:
Journal of Clinical Hepatology
2018;34(9):1921-1924
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the clinical effect of endoscopic application of tissue adhesive and ligation in the treatment of esophagogastric variceal bleeding in children. MethodsA retrospective analysis was performed for the clinical data of 16 children who underwent endoscopic treatment due to esophagogastric variceal bleeding from May 2010 to May 2017. Preoperative conditions and physiological indices and postoperative hemostasis rate, rebleeding rate, complications, and further treatment. ResultsThe mean age of these children was 8.50±4.97 years. Of all children, 5 had esophageal varices alone, among whom 1 had moderate (GII) type and 4 had severe (GIII) type, and 11 had esophageal varices complicated by gastric varices, among whom 6 had GOV1 type (1 complicated by GI type, 3 complicated by GII type, and 2 complicated by GIII type) and 5 had GOV2 type (2 complicated by GII type and 3 complicated by GIII type). There were a total of 50 varicose veins in these 16 children, with a mean number of 4 veins (range 1-5) in each child, and ligation was performed for 70 sites in total, with a mean number of 5 sites (range 0-8) in each child. Tissue adhesive injection was performed for 9 children at a total of 15 sites, and 20 ml of tissue adhesive was used in total, with 2.22 ml for each child and 1.33 ml for each site. The hemostasis rate immediately after endoscopic therapy was 100%, and the rebleeding rate was 6.25% (1/16) within 3 months and 12.5% (2/16) after 3 months. The follow-up time ranged from 3 months to 7 years, and during follow-up, 4 children underwent liver transplantation and 1 underwent endoscopic treatment again due to bleeding. No obvious complications were observed. ConclusionIn the treatment of esophagogastric variceal bleeding in children, endoscopic application of tissue adhesive and ligation has a marked hemostatic effect and few complications and provides valuable time for long-term treatment.
