Document Detail


A prospective, randomized trial of butyl cyanoacrylate injection versus band ligation in the management of bleeding gastric varices.
MedLine Citation:
PMID:  11343232     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Gastric variceal bleeding is a catastrophic event. Both cyanoacrylate injection and banding ligation have been proven to be effective in the management of bleeding gastric varices. This study was performed to compare the efficacy and complications of both the modalities. Cirrhotic patients with a history of gastric variceal bleeding were randomized to 2 groups. The group receiving endoscopic obturation (group A) comprised 31 patients and the group receiving band ligation (group B) comprised 29 patients. Butyl cyanoacrylate and pneumatic-driven ligator were applied, respectively. Treatment was repeated regularly until obliteration of gastric varices. Active bleeding occurred in 15 patients in group A and 11 patients in group B. Initial hemostatic rate (defined as no bleeding for 72 hours after treatment) was 87% in group A and 45% in group B (P = .03). The sessions required to achieve variceal obliteration and obliteration rates were similar in both the groups. However, rebleeding rates were significantly higher in group B (54%) than group A (31%) (P = .0005). Treatment-induced ulcer bleeding occurred in 2 patients (7%) in group A and 8 patients (28%) in group B (P = .03). The amount of blood transfusions required were also higher in group B than group A (4.2 +/- 1.3 vs. 2.6 +/- 0.9 units, respectively) (P < .01). Nine patients of group A and 14 patients of group B died (P = .05). In conclusion, endoscopic obturation using cyanoacrylate proved more effective and safer than band ligation in the management of bleeding gastric varices.
Authors:
G H Lo; K H Lai; J S Cheng; M H Chen; H T Chiang
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Hepatology (Baltimore, Md.)     Volume:  33     ISSN:  0270-9139     ISO Abbreviation:  Hepatology     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-05-08     Completed Date:  2001-05-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8302946     Medline TA:  Hepatology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1060-4     Citation Subset:  IM    
Affiliation:
Division of Gastroenterology, Department of Medicine, Kaohsiung Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan, Republic of China. ghlo@isca.vghks.gov.tw
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Enbucrilate / adverse effects,  therapeutic use*
Endoscopy*
Esophageal and Gastric Varices / complications*
Female
Gastrointestinal Hemorrhage / blood,  etiology*,  mortality,  therapy*
Hemostasis
Humans
Ligation / adverse effects
Male
Middle Aged
Prospective Studies
Sclerosing Solutions / adverse effects,  therapeutic use*
Sclerotherapy*
Chemical
Reg. No./Substance:
0/Sclerosing Solutions; 6606-65-1/Enbucrilate
Comments/Corrections
Comment In:
Hepatology. 2002 Nov;36(5):1298; author reply 1299   [PMID:  12395346 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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