Cyanoacrylate injection versus band ligation for bleeding from cardiac varices along the lesser curvature of the stomach

Sang Jung Park, Yong Kwon Kim, Yeon Seok Seo, Seung Woon Park, Han Ah Lee, Tae Hyung Kim, Sang Jun Suh, Young Kul Jung, Ji Hoon Kim, Hyonggin An, Hyung Joon Yim, Jae Young Jang, Jong Eun Yeon, Soon-Ho Um

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

BACKGROUND/AIMS: Practice guidelines recommend endoscopic band ligation (EBL) and endoscopic variceal obturation (EVO) for bleeding from esophageal varices and fundal varices, respectively. However, the optimal treatment for bleeding from cardiac varices along the lesser curvature of the stomach (GOV1) remains undefined. This retrospective study compared the efficacy between EBL and EVO for bleeding from GOV1.

METHODS: Patients treated by EBL or EVO via cyanoacrylate injection for bleeding from GOV1 were enrolled. Patients diagnosed with hepatocellular carcinoma or treated with endoscopic injection sclerotherapy were excluded.

RESULTS: The study included 91 patients treated for bleeding from GOV1. The mean age was 56.3±10.9 years (mean±SD), and 78 of them (85.7%) were men. Overall, 51 and 40 patients were treated with EBL and EVO, respectively. A trend for a higher hemostasis rate was noted in the EVO group (100%) than in the EBL group (82.6%, P=0.078). Varices rebled in 15 patients during follow-up. The rebleeding rate was significantly higher in the EBL group than in the EVO group (P=0.004). During follow-up, 13 patients died (11 in the EBL group and 2 in the EVO group); the survival rate was marginally significant between two groups (P=0.050). The rebleeding-free survival rate was significantly higher in the EVO group than in the EBL group (P=0.001).

CONCLUSION: Compared to EBL, EVO offered significantly lower rebleeding rates, significantly higher rebleeding-free survival rates, and a trend for higher hemostasis and survival rates. EVO appears to be the better therapeutic option for bleeding from GOV1.

Original languageEnglish
Pages (from-to)487-494
Number of pages8
JournalClinical and molecular hepatology
Volume22
Issue number4
DOIs
Publication statusPublished - 2016 Dec 1

Fingerprint

Cyanoacrylates
Varicose Veins
Ligation
Stomach
Hemorrhage
Injections
Survival Rate
Hemostasis
Sclerotherapy
Esophageal and Gastric Varices
Practice Guidelines
Hepatocellular Carcinoma
Retrospective Studies

Keywords

  • Band ligation
  • Cyanoacrylate
  • Endoscopy
  • Liver cirrhosis
  • Varices

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Cyanoacrylate injection versus band ligation for bleeding from cardiac varices along the lesser curvature of the stomach. / Park, Sang Jung; Kim, Yong Kwon; Seo, Yeon Seok; Park, Seung Woon; Lee, Han Ah; Kim, Tae Hyung; Suh, Sang Jun; Jung, Young Kul; Kim, Ji Hoon; An, Hyonggin; Yim, Hyung Joon; Jang, Jae Young; Yeon, Jong Eun; Um, Soon-Ho.

In: Clinical and molecular hepatology, Vol. 22, No. 4, 01.12.2016, p. 487-494.

Research output: Contribution to journalArticle

@article{13312aa8bc0149f68aa210f0656726cb,
title = "Cyanoacrylate injection versus band ligation for bleeding from cardiac varices along the lesser curvature of the stomach",
abstract = "BACKGROUND/AIMS: Practice guidelines recommend endoscopic band ligation (EBL) and endoscopic variceal obturation (EVO) for bleeding from esophageal varices and fundal varices, respectively. However, the optimal treatment for bleeding from cardiac varices along the lesser curvature of the stomach (GOV1) remains undefined. This retrospective study compared the efficacy between EBL and EVO for bleeding from GOV1.METHODS: Patients treated by EBL or EVO via cyanoacrylate injection for bleeding from GOV1 were enrolled. Patients diagnosed with hepatocellular carcinoma or treated with endoscopic injection sclerotherapy were excluded.RESULTS: The study included 91 patients treated for bleeding from GOV1. The mean age was 56.3±10.9 years (mean±SD), and 78 of them (85.7{\%}) were men. Overall, 51 and 40 patients were treated with EBL and EVO, respectively. A trend for a higher hemostasis rate was noted in the EVO group (100{\%}) than in the EBL group (82.6{\%}, P=0.078). Varices rebled in 15 patients during follow-up. The rebleeding rate was significantly higher in the EBL group than in the EVO group (P=0.004). During follow-up, 13 patients died (11 in the EBL group and 2 in the EVO group); the survival rate was marginally significant between two groups (P=0.050). The rebleeding-free survival rate was significantly higher in the EVO group than in the EBL group (P=0.001).CONCLUSION: Compared to EBL, EVO offered significantly lower rebleeding rates, significantly higher rebleeding-free survival rates, and a trend for higher hemostasis and survival rates. EVO appears to be the better therapeutic option for bleeding from GOV1.",
keywords = "Band ligation, Cyanoacrylate, Endoscopy, Liver cirrhosis, Varices",
author = "Park, {Sang Jung} and Kim, {Yong Kwon} and Seo, {Yeon Seok} and Park, {Seung Woon} and Lee, {Han Ah} and Kim, {Tae Hyung} and Suh, {Sang Jun} and Jung, {Young Kul} and Kim, {Ji Hoon} and Hyonggin An and Yim, {Hyung Joon} and Jang, {Jae Young} and Yeon, {Jong Eun} and Soon-Ho Um",
year = "2016",
month = "12",
day = "1",
doi = "10.3350/cmh.2016.0050",
language = "English",
volume = "22",
pages = "487--494",
journal = "Clinical and molecular hepatology",
issn = "2287-2728",
publisher = "Korean Association for the Study of the Liver",
number = "4",

}

TY - JOUR

T1 - Cyanoacrylate injection versus band ligation for bleeding from cardiac varices along the lesser curvature of the stomach

AU - Park, Sang Jung

AU - Kim, Yong Kwon

AU - Seo, Yeon Seok

AU - Park, Seung Woon

AU - Lee, Han Ah

AU - Kim, Tae Hyung

AU - Suh, Sang Jun

AU - Jung, Young Kul

AU - Kim, Ji Hoon

AU - An, Hyonggin

AU - Yim, Hyung Joon

AU - Jang, Jae Young

AU - Yeon, Jong Eun

AU - Um, Soon-Ho

PY - 2016/12/1

Y1 - 2016/12/1

N2 - BACKGROUND/AIMS: Practice guidelines recommend endoscopic band ligation (EBL) and endoscopic variceal obturation (EVO) for bleeding from esophageal varices and fundal varices, respectively. However, the optimal treatment for bleeding from cardiac varices along the lesser curvature of the stomach (GOV1) remains undefined. This retrospective study compared the efficacy between EBL and EVO for bleeding from GOV1.METHODS: Patients treated by EBL or EVO via cyanoacrylate injection for bleeding from GOV1 were enrolled. Patients diagnosed with hepatocellular carcinoma or treated with endoscopic injection sclerotherapy were excluded.RESULTS: The study included 91 patients treated for bleeding from GOV1. The mean age was 56.3±10.9 years (mean±SD), and 78 of them (85.7%) were men. Overall, 51 and 40 patients were treated with EBL and EVO, respectively. A trend for a higher hemostasis rate was noted in the EVO group (100%) than in the EBL group (82.6%, P=0.078). Varices rebled in 15 patients during follow-up. The rebleeding rate was significantly higher in the EBL group than in the EVO group (P=0.004). During follow-up, 13 patients died (11 in the EBL group and 2 in the EVO group); the survival rate was marginally significant between two groups (P=0.050). The rebleeding-free survival rate was significantly higher in the EVO group than in the EBL group (P=0.001).CONCLUSION: Compared to EBL, EVO offered significantly lower rebleeding rates, significantly higher rebleeding-free survival rates, and a trend for higher hemostasis and survival rates. EVO appears to be the better therapeutic option for bleeding from GOV1.

AB - BACKGROUND/AIMS: Practice guidelines recommend endoscopic band ligation (EBL) and endoscopic variceal obturation (EVO) for bleeding from esophageal varices and fundal varices, respectively. However, the optimal treatment for bleeding from cardiac varices along the lesser curvature of the stomach (GOV1) remains undefined. This retrospective study compared the efficacy between EBL and EVO for bleeding from GOV1.METHODS: Patients treated by EBL or EVO via cyanoacrylate injection for bleeding from GOV1 were enrolled. Patients diagnosed with hepatocellular carcinoma or treated with endoscopic injection sclerotherapy were excluded.RESULTS: The study included 91 patients treated for bleeding from GOV1. The mean age was 56.3±10.9 years (mean±SD), and 78 of them (85.7%) were men. Overall, 51 and 40 patients were treated with EBL and EVO, respectively. A trend for a higher hemostasis rate was noted in the EVO group (100%) than in the EBL group (82.6%, P=0.078). Varices rebled in 15 patients during follow-up. The rebleeding rate was significantly higher in the EBL group than in the EVO group (P=0.004). During follow-up, 13 patients died (11 in the EBL group and 2 in the EVO group); the survival rate was marginally significant between two groups (P=0.050). The rebleeding-free survival rate was significantly higher in the EVO group than in the EBL group (P=0.001).CONCLUSION: Compared to EBL, EVO offered significantly lower rebleeding rates, significantly higher rebleeding-free survival rates, and a trend for higher hemostasis and survival rates. EVO appears to be the better therapeutic option for bleeding from GOV1.

KW - Band ligation

KW - Cyanoacrylate

KW - Endoscopy

KW - Liver cirrhosis

KW - Varices

UR - http://www.scopus.com/inward/record.url?scp=85014846525&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85014846525&partnerID=8YFLogxK

U2 - 10.3350/cmh.2016.0050

DO - 10.3350/cmh.2016.0050

M3 - Article

C2 - 28081588

AN - SCOPUS:85014846525

VL - 22

SP - 487

EP - 494

JO - Clinical and molecular hepatology

JF - Clinical and molecular hepatology

SN - 2287-2728

IS - 4

ER -