Low Incidence of Complications From Endoscopic Gastric Variceal Obturation With Butyl Cyanoacrylate

• Published in: Clinical gastroenterology and hepatology Vol. 8; no. 9; pp. 760 - 766
• Main Authors: Cheng, Liu–Fang, Wang, Zhi–Qiang, Li, Chang–Zheng, Lin, Wu, Yeo, Anthony E.T, Jin, Bo
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2010
• Subjects: Ectopic Embolism; Embolism - epidemiology; Enbucrilate - adverse effects; Enbucrilate - therapeutic use; Endoscopy - adverse effects; Esophageal and Gastric Varices - surgery; Female; Gastric Variceal Obliteration; Gastroenterology and Hepatology; Hemoperitoneum - epidemiology; Hemorrhage - surgery; Histoacryl; Humans; Incidence; Male; Middle Aged; Peritonitis - epidemiology; Recurrence; Recurrent Variceal Bleeding; Retrospective Studies; Sepsis - epidemiology; Stomach Ulcer - epidemiology; Tissue Adhesives - adverse effects; Tissue Adhesives - therapeutic use; computed tomography; endoscopic variceal ligation; Gastric Variceal Obliteration; EVS; endoscopic variceal sclerotherapy; transjugular intrahepatic portosystemic shunt; CI; Ectopic Embolism; Beijing Shijitan Hospital; GOV; isolated gastric varices; CT; Recurrent Variceal Bleeding; Histoacryl; BSH; General Hospital of Chinese People's Liberation Army; IGV; confidence interval; EVL; gastroesophageal varices; endoscopic variceal obturation; GHCPLA; EVO; TIPS
• ISSN: 1542-3565; 1542-7714
• DOI: 10.1016/j.cgh.2010.05.019

Background & Aims Endoscopic variceal obturation with tissue adhesive is used to control gastric variceal bleeding. We investigated the prevalence of serious complications from this therapy. Methods We performed a retrospective analysis of complications that occurred in 753 patients with gastric variceal hemorrhages who were hospitalized in 2 tertiary referral hospitals. All patients received N -butyl-2-cyanoacrylate as therapy for endoscopic variceal obturation. Results Complications occurred in 51 patients. Thirty-three patients experienced rebleeding because of early-onset (within 3 months) extrusion of the N -butyl-2-cyanoacrylate glue cast (4.4%), 10 patients developed sepsis (1.3%), and 5 patients developed distant embolisms (0.7%; 1 pulmonary, 1 brain, and 3 splenic). One patient had major gastric variceal bleeding after endoscopic variceal obturation (0.1%), 1 developed a large gastric ulcer (0.1%), and 1 had mesentery hematoma, hemoperitoneum, and infection in the abdominal cavity (0.1%). The complication-related mortality was 0.53% (3 deaths from sepsis and 1 death from rebleeding after early-onset glue cast extrusion). Conclusions The occurrence of complications after endoscopic variceal obturation with N -butyl-2-cyanoacrylate in gastric varices treatment is rare.