Value of clip-assisted endoscopic cyanoacrylate injection for gastric varices

doi:10.3877/cma.j.issn.2095-2015.2019.06.004

Abstract

Abstract:

Objective

To investigate the safety, efficacy and operation cautions of clip-assisted endoscopic cyanoacrylate injection for patients with gastric varices.

Methods

A retrospective study was performed on the data of 10 patients with gastric varices undergoing clip-assisted endoscopic cyanoacrylate injection in Department of Gastroenterology of Eastern District of Shandong Provincial Hospital Affiliated to Shandong University from January 2018 to July 2019.GOV2/IGV1 was confirmed by endoscopy examination and a gastro-renal shunt was confirmed by contrast-enhanced CT and CT angiography(CTA)for all patients.The inflow or outflow veins of the gastric varices were observed and clamped with metal clips to slow down or completely block the gastric variceal blood flow, followed by cyanoacrylate injection into the gastric varices, which could reduce the risk of ectopic embolization.The technical successful rate, the eradication of gastric varices, the rebleeding rate and complications were analyzed.

Results

All patients successfully completed the procedure.The mean follow-up was 85.7 days(range 39-157 days). Gastric varices were eradicated in all patients according to contrast-enhanced CT reexamination.Rebleeding occurred in one patient because of post-injection ulcer.No symptoms related to ectopic embolization occurred.No serious complications occurred.

Conclusion

Clip-assisted endoscopic cyanoacrylate injection is safe and reliable for gastric varices patients with gastro-renal shunt, which deserves further clinical research.

Key words: Gastric varices, Endoscopic therapy, Clip-assisted endoscopic cyanoacrylate injection, Gastro-renal shunt, Ectopic embolization

Mingyan Zhang, Suyun Jin, Ruonan Sun, Guangchuan Wang, Yongjun Shi, Hua Feng, Jinhua Hu, Chunqing Zhang. Value of clip-assisted endoscopic cyanoacrylate injection for gastric varices[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2019, 09(06): 252-255.

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URL: https://zhxhbyyxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-2015.2019.06.004

https://zhxhbyyxzz.cma-cmc.com.cn/EN/Y2019/V09/I06/252

Figures/Tables 2

References 12

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编号	年龄(岁)	性别	病因	肝静脉压力梯度(mmHg)	胃静脉曲张类型	胃肾分流直径(mm)	钛夹数量(个)	组织胶量(ml)	异位栓塞	随访时间(d)	再出血
1	66	男	酒精性	15	IGV1	16	3	7.5	无	157	无
2	65	女	乙型肝炎	16	GOV2	7	3	7.5	无	140	无
3	54	男	乙型肝炎	10	GOV2	10	4	4.5	无	124	无
4	55	男	酒精性	－	IGV1	14	5	3.5	无	103	有，排胶溃疡
5	47	女	自身免疫性	－	IGV1	12	3	3.5	无	95	无
6	54	男	乙型肝炎	－	IGV1	10	2	4	无	47	无
7	52	男	不明原因	11(有侧支)	GOV2	5	2	4.5	无	49	无
8	76	女	不明原因	18	GOV2	8	3	6.5	无	39	无
9	64	女	乙型肝炎	－	IGV1	7	4	4.0	无	52	无
10	58	男	酒精性	－	IGV1	14	2	2.0	无	51	无

编号	年龄(岁)	性别	病因	肝静脉压力梯度(mmHg)	胃静脉曲张类型	胃肾分流直径(mm)	钛夹数量(个)	组织胶量(ml)	异位栓塞	随访时间(d)	再出血
1	66	男	酒精性	15	IGV1	16	3	7.5	无	157	无
2	65	女	乙型肝炎	16	GOV2	7	3	7.5	无	140	无
3	54	男	乙型肝炎	10	GOV2	10	4	4.5	无	124	无
4	55	男	酒精性	－	IGV1	14	5	3.5	无	103	有，排胶溃疡
5	47	女	自身免疫性	－	IGV1	12	3	3.5	无	95	无
6	54	男	乙型肝炎	－	IGV1	10	2	4	无	47	无
7	52	男	不明原因	11(有侧支)	GOV2	5	2	4.5	无	49	无
8	76	女	不明原因	18	GOV2	8	3	6.5	无	39	无
9	64	女	乙型肝炎	－	IGV1	7	4	4.0	无	52	无
10	58	男	酒精性	－	IGV1	14	2	2.0	无	51	无

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