A miniature ultrasound probe is useful in reducing rebleeding after endoscopic cyanoacrylate injection for hemorrhagic gastric varices.

Abstract

OBJECTIVE:

To better assess the usefulness of miniature ultrasound probe (MUP) sonography in the evaluation of the adequacy of gastric variceal injection with cyanoacrylate to decrease the risk of post injection rebleeding.

MATERIAL AND METHODS:

Sixty-nine patients with bleeding gastric varices were included in this study. Endoscopic cyanoacrylate injection was performed in the acute phase for variceal hemostasis. After injection, patients (n = 34) included in the MUP group prospectively received endoscopic ultrasonography (EUS) with MUP during each scheduled endoscopic follow-up session. Patients (n = 35) in the control group who were included historically were followed up with the same interval with endoscopy only.

RESULTS:

Four (11.4%) patients in the control group received reinjection, and there were 10 episodes of rebleeding in 7 (20.0%) patients. Nine (26.5%) patients received reinjection due to inadequate obturation as judged by EUS. There were six episodes of rebleeding in three (8.8%) patients in the MUP group. The free-of-rebleeding rate for the MUP group was significantly higher than that for the control group (p < 0.05). The cumulative survival for the MUP group was slightly better than that for the control group but was not statistically significant. The patients' compliance in both groups was similar. The endosonographers considered the performance of MUP sonography to be convenient.

CONCLUSIONS:

MUP sonography is useful for the evaluation of the adequacy of tissue adhesive obturation of gastric varices that may reduce the probability of rebleeding.

• Authors: Szu-Chia Liao, Sheng-Shun Yang, Chun-Wang Ko, Han-Chung Lien, Chun-Fang Tung, Yen-Chun Peng, Hong-Zen Yeh, Chi-Sen Chang
• Journal: Scandinavian journal of gastroenterology (Scand J Gastroenterol) Vol. 48 Issue 11 Pg. 1347-53 (Nov 2013) ISSN: 1502-7708 [Electronic] England
• PMID: 24073667 (Publication Type: Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Tissue Adhesives
• Enbucrilate

Topics

• Adult
• Aged
• Enbucrilate (administration & dosage)
• Endosonography (instrumentation)
• Esophageal and Gastric Varices (prevention & control)
• Female
• Gastrointestinal Hemorrhage (prevention & control)
• Humans
• Male
• Middle Aged
• Recurrence
• Sclerotherapy
• Tissue Adhesives (administration & dosage)
• Treatment Outcome