Portal HypertensionLong-term results of endoscopic Histoacryl injection sclerotherapy for gastric variceal bleeding: A 10-year experience☆
Section snippets
Patients and methods
Between January 1982 and June 2001, 101 patients with acute bleeding from gastric varices were admitted to our facility. Among them, 52 patients underwent endoscopic injection of Histoacryl combined with Ethanolamine oleate (Grelan Pharmaceutical Co, Ltd, Tokyo, Japan) (EO) for the purpose of either hemostasis or prevention of recurrent gastric variceal bleeding. All 52 patients had active bleeding (spurting or oozing). The liver function was classified according to the Child-Pugh
Results
The initial hemostasis rate was 96.2% (Table II). Among the 52 patients, there were 2 patients who did not achieve hemostasis. The average number of sessions required to eradicate the gastric varices was 2.9 ± 1.2 times. The median duration of follow-up in this study was 28.1 ± 34.0 months (range: 1 day to 121.3 months). Two patients had recurrent bleeding within 48 hours. Three patients died because of recurrent massive bleeding. However, most recurrent bleeding was not serious and could be
Discussion
Histoacryl (N-butyl-cyanoacrylate) is the only endoscopic treatment that has been shown to be effctive. In 1986, Soehendra et al4 reported that bleeding gastric varices could be effectively treated by sclerotherapy using the tissue adhesive agent butyl cyanoacrylate. Since then several authors have used this agent in the treatment of bleeding gastric varices. In this study the rate of acute hemostasis was comparable with or better than that in most series of patients treated with a tissue
References (21)
- et al.
Endoscopic injection sclerosis in bleeding gastric varices
Gastrointest Endosc
(1986) - et al.
Endoscopic treatment of bleeding gastric varices by N-butyl-2-cyanoacrylate (Histoacryl) injection: long-term efficacy and safety
Gastrointest Endosc
(2000) - et al.
Gastric variceal ligation: a new technique
Gastrointest Endosc
(1999) - et al.
A prospective, randomized trial of butyl cyanoacrylate injection versus band ligation in the management of bleeding gastric varices
Hepatology
(2001) - et al.
Endoscopic classification of gastric varicies
Gastrointest Endosc
(1990) - et al.
Effectiveness of gastric devascularization and splenectomy for patients with gastric varices
J Am Coll Surg
(2000) - et al.
Laparoscopic gastric devascularization and splenectomy for sclerotherapy-resistant esophagogastric varices with hypersplenism
J Am Coll Surg
(1998) - et al.
Long-term results of balloon-occluded retrograde transvenous obliteration for the treatment of gastric varices and hepatic encephalopathy
J Vasc Interv Radiol
(2001) - et al.
Eight years of experience with transjugular retrograde obliteration for gastric varices with gastrorenal shunt
Surgery
(2001) - et al.
Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients
Hepatology
(1992)
Cited by (0)
- ☆
Reprint requests: Tomohiko Akahoshi, MD, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka 812, Japan.