Long-term outcomes of prophylactic endoscopic histoacryl injection for gastric varices with a high risk of bleeding

Yun Jung Chang, Jong Jae Park, Moon Kyung Joo, Beom Jae Lee, Jae Won Yun, Dae Woong Yoon, Ji Hoon Kim, Jong Eun Yeon, Jae Seon Kim, Kwan Soo Byun, Young Tae Bak

    Research output: Contribution to journalArticlepeer-review

    21 Citations (Scopus)

    Abstract

    Purpose: Endoscopic histoacryl injection (EHI) is reported to be an effective treatment modality for bleeding gastric varices (GVs) but controversial as a prophylactic treatment for non-bleeding GVs because efficacy and safety have yet to be determined. The aim of this study was to evaluate safety and long-term outcomes of prophylactic EHI for non-bleeding GVs with a high risk of bleeding. Methods: Thirty-three patients (23 males/10 females, mean age 56.6 years old) with a high risk of gastric variceal bleeding (large tumorous (27), red color sign (14) or rapidly growing in size (1)) underwent EHI. According to the grade of GVs, 25 patients belonged to F3, seven to F2, and one to F1. In terms of the locations of GVs, four patients belonged to type IGV1, 21 to type GOV2, and eight to type GOV1. Results: Obliteration of GVs was achieved in all of the treated patients. Twenty-three patients required one session and ten needed more than two sessions to obliterate their GVs. A mean volume of histoacryl used per session was 2.0 ml. Complications related to the procedure included immediate bleeding in two patients and bacteremia in one patient. The mean duration of follow-up was 12.2 months and eradication of GVs was achieved in 21 (95%) of 22 patients who were followed-up more than 3 months. Index GVs recurred in three of 21 patients (14%) and re-bleeding in index GVs after EHI occurred in two of 26 patients (8%). Conclusions: Prophylactic EHI can be a promising procedure for eradication of non-bleeding GVs in case with a high risk of bleeding.

    Original languageEnglish
    Pages (from-to)2391-2397
    Number of pages7
    JournalDigestive Diseases and Sciences
    Volume55
    Issue number8
    DOIs
    Publication statusPublished - 2010 Aug

    Keywords

    • Butyl cyanoacrylate
    • Endoscopic sclerotherapy
    • Gastric varices

    ASJC Scopus subject areas

    • Physiology
    • Gastroenterology

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