Endoscopic hemostasis for bleeding gastric varices treated by combination of variceal ligation and sclerotherapy with N-butyl-2-cyanoacrylate

Sugimoto, Nozomi; Watanabe, Kenichiro; Watanabe, Kazuyo; Ogata, Shinichi; Shimoda, Ryo; Sakata, Hiroyuki; Eguchi, Yuichiro; Mizuta, Toshihiko; Tsunada, Seiji; Iwakiri, Ryuichi; Nojiri, Junichi; Mizuguchi, Masanobu; Kudo, Sho; Miyazaki, Kohji; Fujimoto, Kazuma
July 2007
Journal of Gastroenterology;Jul2007, Vol. 42 Issue 7, p528
Academic Journal
Bleeding from esophagogastric varices is a serious complication of portal hypertension. The aim of the present study was to determine whether endoscopic sclerotherapy with injection of N-butyl-2-cyanoacrylate combined with variceal ligation was useful for hemostasis of bleeding gastric varices. Twenty-seven patients with bleeding gastric varices underwent endoscopic treatment with variceal ligation followed by sclerotherapy with N-butyl-2-cyanoacrylate from November 1995 to November 2000. Patients underwent endoscopic variceal ligation only for the bleeding spot just before sclerotherapy. Injection was continued until varices were engorged. After these therapies, patients were followed for at least for 5 years. Retreatment was applied as necessary. Among these patients, 11 had active bleeding and 16 had recent bleeding within 24 h with white or red plaques on gastric varices. All varices presented as nodular or tumorous forms. The hemostasis rate at 1 week after treatment with N-butyl-2-cyanoacrylate was 88.9% (24/27). Among the patients achieving hemostasis at 1 week, 33.3% (8/24) experienced recurrent bleeding between 5 and 53 months after the initial treatment. Five patients with rebleeding were treated with N-butyl-2-cyanoacrylate, and the other three patients were treated by other procedures. The final hemostasis rate was 81.5% (22/27). The 5-year survival rate after initial hemostasis was 63.0% (17/27). This study showed that endoscopic variceal ligation combined with sclerotherapy might become a recommended choice for effective treatment of bleeding gastric varices.


Related Articles

  • ROLE ENDOSCOPY IN CHOOSING METHODS OF PREVENTING ISSUE OF BLOOD FROM VARICOSE VEINS OF OESOPHAGUS. Tashkinov, N. V.; Kachalov, S. N.; Sigaeva, Yu. S.; Chichkan, S. I.; Pyrkh, A. V. // Pacific Medical Journal / Tihookeanskij Medicinskij Zurnal;Dec2011, Issue 4, p78 

    The authors analyse results of endoscopic prevention of recurrent issues of blood from varicose veins of oesophagus in 37 patients with portal hypertension syndrome. The primary group (17 patients) underwent endoscopic ultrasound-controlled ligation of veins. The control group underwent...

  • Gross and Microscopic Findings in the Human Esophagus after Esophageal Variceal Band Ligation: A Postmortem Analysis. Marks, Robert D.; Arnold, Muoi D.; Baron, Todd H. // American Journal of Gastroenterology;Feb1993, Vol. 88 Issue 2, p272 

    Endoscopic sclerotherapy has been the therapy of choice for controlling acute variceal hemorrhage. Recently, endoscopic band ligation has been utilized for the management of esophageal varices with fewer complications and greater efficacy. We report the pathologic findings in the human esophagus...

  • Massive Bleeding from Rectal Varices. Herman, Barry E.; Baum, Stephen; Denobile, John; Volpe, Rocco J. // American Journal of Gastroenterology;Jun1993, Vol. 88 Issue 6, p939 

    An elderly female who experienced a life-threatening bleed from an isolated rectal varix is presented. She failed endoscopic injection sclerotherapy but responded to surgical ligation. The literature concerning well-documented bleeding from eight cases of rectal varices is reviewed....

  • Endoscopic Injection Sclerotherapy for Esophageal Varices Using a Transparent Hood. Horigome, Hideo; Nomura, Tomoyuki; Nakao, Haruhisa; Kanematsu, Takayoshi; Joh, Takashi; Ohara, Hirotaka // American Journal of Gastroenterology;Dec2000, Vol. 95 Issue 12, p3679 

    Discusses the use of transparent hood in the administration of endoscopic injection sclerotherapy (EIS) for esophageal varices. Description of the administration of EIS; Comparison of EIS with endoscopic variceal ligation; Advantages of using transparent hood in the administration of EIS.

  • A Review of Current Treatment Strategies for Varicose Veins. Badri, Hassan; Bhattacharya, Vish // Recent Patents on Cardiovascular Drug Discovery;Jun2008, Vol. 3 Issue 2, p126 

    Objectives: To systematically review data to determine if Endovenous Laser Ablation (EVLA), Radio Frequency Ablation (RFA), and Foam Sclerotherapy (FS) have any advantages or disadvantages in comparison with conventional surgical ligation and stripping of great saphenous vein (GSV) varices. EVLA...

  • Guidelines and recommendation on surgery for venous incompetence and leg ulcer. Sarma, Nilendu // Indian Dermatology Online Journal;Jul-Sep2014, Vol. 5 Issue 3, p390 

    The article presents guidelines on different types of surgery for venous incompetence and leg ulcer including recommendations depending on the state of the venous incompetence. Topics covered include the ligation, division and stripping of either the great saphenous vein or short saphenous vein,...


    Compares the effectiveness of the use of sclerotherapy with compression or stripping with multiple ligations in the treatment of varicose veins. Background information on sclerotherapy; Injection therapy; Increasing the chances of fibrosis; Side effects.

  • What treatments are effective for varicose veins? Hagen, Michael D.; Johnson, E. Diane; Adelman, Alan // Journal of Family Practice;Apr2003, Vol. 52 Issue 4, p329 

    This article presents various treatments for varicose veins. Therapeutic options include conservative measures, injection sclerotherapy, surgical vein ligation, laser and thermal ablation and venotonic medications. A randomized trial among 121 subjects revealed that long-term outcomes are...

  • Bleeding from gastric body varices effectively treated with endoscopic band ligation. Sato, Takahiro; Kitagawa, Sho // International Medical Case Reports Journal;2012 Part 2, Vol. 5, p69 

    A 55-year-old man with alcoholic liver cirrhosis was admitted to hospital with tarry stools. Videoendoscopy examination on admission revealed blood oozing from the greater curvature of the gastric body (ectopic varices). Endoscopic ultrasonography and computed tomography were used in making the...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics