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Endoscopic treatment of bleeding gastric varices with histoacryl (N-butyl-2-cyanoacrylate): a South European single center experience

2013-07Journal article Open access
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dc.contributor.authorMonsanto, P
dc.contributor.authorAlmeida, N
dc.contributor.authorRosa, A
dc.contributor.authorMaçôas, F
dc.contributor.authorLérias, C
dc.contributor.authorPortela, F
dc.contributor.authorAmaro, P
dc.contributor.authorFerreira, MC
dc.contributor.authorGouveia, H
dc.contributor.authorSofia, C
dc.date.accessioned2016-05-12T09:23:01Z
dc.date.available2016-05-12T09:23:01Z
dc.date.issued2013-07
dc.description.abstractBACKGROUND: Endoscopic injection of N-butyl-2-cyanoacrylate is the current recommended treatment for gastric variceal bleeding. Despite the extensive worldwide use, there are still differences related to the technique, safety, and long term-results. We retrospectively evaluated the efficacy and safety of cyanoacrylate in patients with gastric variceal bleeding. PATIENTS AND METHODS: Between January 1998 and January 2010, 97 patients with gastric variceal bleeding underwent endoscopic treatment with a mixture of N-butyl-2-cyanoacrylate and Lipiodol(TM). Ninety-one patients had cirrhosis and 6 had non-cirrhotic portal hypertension. Child-Pugh score at presentation for cirrhotic patients was A-12.1 %; B-53.8 %; C-34.1 % and median MELD score at admission was 13 (3-26). Successful hemostasis, rebleeding rate and complications were reviewed. Median time of follow up was 19 months (0.5-126). RESULTS: A median mixture volume of 1.5 mL (0.6 to 5 mL), in 1 to 8 injections, was used, with immediate hemostasis rate of 95.9 % and early rebleeding rate of 14.4 %. One or more complications occurred in 17.5 % and were associated with the use of Sengstaken-Blakemore tube before cyanoacrylate and very early rebleeding (p < 0.05). Hospital mortality rate during initial bleeding episode was 9.3 %. Very early rebleeding was a strong and independent predictor for in-hospital mortality (p < 0.001). Long-term mortality rate was 58.8 %, in most of the cases secondary to hepatic failure. CONCLUSION: N-butyl-2-cyanoacrylate is a rapid, easy and highly effective modality for immediate hemostasis of gastric variceal bleeding with an acceptable rebleeding rate. Patients with very early rebleeding are at higher risk of death.pt_PT
dc.identifier.citationIndian J Gastroenterol. 2013 Jul;32(4):227-31.pt_PT
dc.identifier.doi10.1007/s12664-012-0191-3pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.4/1913
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectEnbucrilatept_PT
dc.subjectEndoscopia Gastrointestinalpt_PT
dc.subjectHemorragia Gastrointestinalpt_PT
dc.subjectEscleroterapiapt_PT
dc.subjectHemostase Endoscópicapt_PT
dc.subjectVarizes Esofágicas e Gástricaspt_PT
dc.titleEndoscopic treatment of bleeding gastric varices with histoacryl (N-butyl-2-cyanoacrylate): a South European single center experiencept_PT
dc.typejournal article
dspace.entity.typePublication
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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