A retrospective comparative study of histoacryl injection and banding ligation in the treatment of acute type 1 gastric variceal hemorrhage. (1st October 2013)

• Record Type: Journal Article
• Authors: Lo, Gin-Ho; Lin, Chih-Wen; Perng, Daw-Shyong; Chang, Chi-Yang; Lee, Ching-Tai; Hsu, Chuan-Yuan; Wang, Huay-Min; Lin, Hui-Chen
• Is Part Of: Scandinavian journal of gastroenterology. Volume 48:Number 10(2013)
• Page Start: 1198
• Page End: 1204
• Publication Date: 2013-10-01
• Subjects: banding ligation -- gastric varices -- glue injection; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.3109/00365521.2013.832792
• Languages: English
• ISSNs: 0036-5521

Abstract

Abstract: Background. Esophageal varices extending along lesser curvature side of stomach is classified as GOV1. The optimal therapy for GOV1 bleeding is still undetermined. Methods. One hundred and sixty-two patients diagnosed as acute hemorrhage from GOV1 were enrolled. At endoscopists' discretion, 118 patients received glue injection (Glue group) and 44 patients received ligation to arrest bleeding [endoscopic variceal ligation (EVL) group]. This study aimed to compare hemostasis, rebleeding, complications and mortality within 42 days. Results. Both groups were comparable in baseline data. In 109 patients (92%) in the Glue group and 36 patients (82%) in the EVL group ( p = 0.07) 48-h hemostasis was achieved . Hemostasis of active bleeding was achieved in 49 of 55 patients (89%) in the Glue group and 24 of 28 patients (85%) in the EVL group ( p = 0.70). Treatment failure was noted in 14% of the Glue group and 23% in the EVL group ( p = 0.22). Eight patients in the Glue group and four patients in the EVL group rebled between 5 and 42 days ( p = 0.73). A total of 48 and 19 adverse events occurred in the Glue and EVL groups, respectively ( p = 0.85). Six patients in the Glue group and seven patients in the EVL group encountered posttreatment gastric ulcer bleeding ( p = 0.04). Seventeen patients (14%) in the Glue group and 10 (23%) patients in the EVL group died within 42 days ( p < 0.001). Conclusions. Banding ligation was similar to glue injection in achieving successful hemostasis of acute bleeding from GOV1. However, a higher incidence of posttreatment ulcer bleeding and mortality may be associated with banding ligation.