Efficacy of endoscopic ultrasound-guided paraesophageal varices puncture cyanoacrylate selective seal for liver cirrhosis complicated with esophageal varices (with video)
10.3760/cma.j.cn321463-20240624-00212
- VernacularTitle:超声内镜引导下食管外侧支静脉穿刺组织胶选择性封闭术治疗肝硬化伴食管静脉曲张的有效性（含视频）
- Author:
Lingling HE
1
;
Yijun LIN
1
;
Xiaohui YE
1
;
Lu ZHU
1
;
Ping LI
1
Author Information
1. 首都医科大学附属北京地坛医院消化科，北京 100015
- Publication Type:Journal Article
- Keywords:
Ultrasonography;
Varicose veins;
Esophageal;
Tissue glue
- From:
Chinese Journal of Digestive Endoscopy
2025;42(7):565-568
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of endoscopic ultrasound-guided paraesophageal varices puncture cyanoacrylate selective seal for liver cirrhosis complicated with esophageal varices.Methods:Data of 86 patients with liver cirrhosis complicated with esophageal varices undergoing endoscopic ultrasound-guided paraesophageal varices puncture cyanoacrylate selective seal (the treatment group, n=40) and conventional endoscopic tissue glue injection treatment (the control group, n=46) were retrospectively collected from Beijing Ditan Hospital from January 2023 to October 2023. The reduced percentage of severe varicose veins, the amount of tissue glue used during operation, the number of punctures and the rate of rebleeding in six months were compared. Results:There were no significant differences in the baseline data including gender, age, blood routine index, liver and kidney functions, proportion of severity varicose veins between the two groups ( P>0.05). In the treatment group, severe varicose veins accounted for 90.0% (36/40) before treatment while it was 12.5% (5/40) after the treatment, and the proportion of severe varicose veins decreased by 77.5%. In the control group, the proportion of severe varicose veins was 89.1% (41/46) before while it was 43.5% (20/46) after the treatment, and the proportion of severe varicose veins decreased by 45.6%. The proportion of severe varicose veins decreased more in the treatment group than that in the control group ( χ2=13.86, P<0.001). Compared with the control group, the median amount of tissue glue applied in the treatment group was significantly less (2.5 mL VS 3.0 mL, Z=-3.55, P<0.001), and the median number of punctures was also significantly less (2 VS 6, Z=-7.10, P<0.001). There was no significant difference in the rate of rebleeding within six months after the treatment between the two groups [12.5% (5/40) VS 10.9% (5/46), χ2=0.06, P=0.814]. Conclusion:For patients with cirrhosis complicated with esophageal varices, endoscopic ultrasound-guided paraesophageal varices puncture cyanoacrylate selective seal demonstrates superior efficacy over conventional endoscopic treatment, with less tissue glue applied, which is worth of promotion and application in clinical practice.
