Abstract | BACKGROUND AND STUDY AIMS: For several years now there has been an increasingly widespread use of a tissue adhesive in the treatment of bleeding gastric varices to achieve rapid, safe control of hemostasis and prevent rebleeding. In this study we report on our experience with the use of Bucrylate (Hystoacryl) for the treatment of gastric varices over a period of more than a decade. PATIENTS AND METHODS: RESULTS: The hemostasis (97.1%), early rebleeding (15.5%), and hospital mortality (19.5%) rates of the patients with bleeding gastric varices, treated with the tissue adhesive, were very similar to those of patients treated for esophageal varices over the same period (98.1%, 13.0%, and 16.4%, respectively). The most frequent cause of death at 30 days was liver failure (76% of cases), followed by hemorrhagic shock (8.8%), and other less frequent causes. Sclerotherapy achieved obliteration rate for gastric varices (70-75%) similar to that for esophageal varices in those patients with portal hypertension due to intrahepatic block (alcoholic and posthepatitis cirrhosis), but a rate of only 32% in the group of patients with prehepatic block (splenoportomesenteric thrombosis), where surgery proved more effective (69%). The medium- and long-term survival rates depended on the stability of the patients' liver conditions, on rapid, effective control of variceal hemostasis, and on complete, lasting obliteration of the gastric varices. CONCLUSIONS:
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Authors | R Kind, A Guglielmi, L Rodella, F Lombardo, F Catalano, A Ruzzenente, G Borzellino, R Girlanda, F Leopardi, F Pratticò, C Cordiano |
Journal | Endoscopy
(Endoscopy)
Vol. 32
Issue 7
Pg. 512-9
(Jul 2000)
ISSN: 0013-726X [Print] Germany |
PMID | 10917182
(Publication Type: Journal Article)
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Chemical References |
- Tissue Adhesives
- Bucrylate
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Topics |
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Bucrylate
(administration & dosage, adverse effects)
- Child
- Drug Administration Schedule
- Esophageal and Gastric Varices
(etiology, mortality, therapy)
- Female
- Follow-Up Studies
- Gastrointestinal Hemorrhage
(etiology, mortality, therapy)
- Gastroscopy
- Humans
- Male
- Middle Aged
- Recurrence
- Sclerotherapy
- Survival Rate
- Tissue Adhesives
(administration & dosage, adverse effects)
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