Efficacy and safety of endoscopic embolization with Glubran-2 glue for gastric varices in liver cirrhosis
10.3760/cma.j.issn.1008-5734.2014.03.005
- VernacularTitle:Glubran-2胶栓塞术治疗肝硬化胃静脉曲张的疗效和安全性观察
- Author:
Shibin ZHANG
1
;
Yanming SONG
1
;
Li FENG
1
;
Yuan ZHAO
1
;
Huiguo DING
1
Author Information
1. 100069,首都医科大学附属北京佑安医院消化中心
- Publication Type:Journal Article
- Keywords:
Embolization,therapeutic;
Esophageal and gastric varices;
Liver cirrhosis;
N-butyl-2-cyanoacrylate glue
- From:
Adverse Drug Reactions Journal
2014;(3):139-142
- CountryChina
- Language:Chinese
-
Abstract:
Objective To preliminarily evaluate efficacy and safety of endoscopic embolization with Glubran-2 glue for gastric varices in liver cirrhosis. Methods Forty-nine patients with cirrhosis gastric varices,admitted to Beijing You′an Hospital from January 2011 to December 2012,underwent endoscopic embolization with Glubran-2 glue under gastroscopy. Of the 49 cases,40 were males and 9 females with age of 34-82(55 ± 11)years. Of these patients,19 were at Child-Pugh class A,23 class B,and 7 class C. Of the 49 patients,22(44. 9%)had isolated gastric varices(IGV)and 27 patients(55. 1%)had gastro-esophaged varices( GOV ). The methods were as follows:50% glucose was prefilled in injection syringe and,after injecting Glubran-2 glue at the location of gastric varices,the left Glubran-2 glue in injection syringe was injected into the varicose vein via the 50% glucose. The Glubran-2 glue was given by way of one spot or multiple spot and each spot needed Glubran-2 glue 1. 0-3. 0 ml. The endoscopic embolization completed at one time as possible. The situation of varicose veins disappearing was observed under gastroscopy at months 1,3,6 after treatment. Safety evaluation index included postoperative burning sensation below the xiphoid,ectopic embolism,fever,blood routine test before operation and at 3 days after operation,and liver and renal functions before operation and at months 1,3,6 after operation. Results The total dose of Glubran-2 glue for IGV patients was 2. 0-12. 0 ml every patient with an average dose of (4. 7 ± 2. 6)ml and for GOV patients was 1. 0-9. 0 ml with an average dose of(4. 2 ± 2. 1)ml. Of the 49 patient,varicose veins of 45 patients(91. 8%)disappeared and varicose veins of 4 patients(8. 2%) improved;extrusions of glue was seen in 18 patients(36. 7%)at one month,30 patients(61. 3%)at 3 month,and 1 patient(2. 0%)at 6 months after treatment. All the patients experienced burning sensation below the xiphoid after glue injection. Three patients presented with fever after operation but their temperature did not exceed 38 ℃. No patient developed ectopic embolism. Nine patients(18. 4%)deve-loped errhysis due to local ulcer because of extrusions of glue and massive haemorrhage did not occur. There were no obvious differences in blood routine test and liver and renal functions before and after treatment. Conclusion Endoscopic embolization with Glubran-2 glue is effective and safe for treatment of gastric varices in liver cirrhosis patients.
