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http://hdl.handle.net/10400.4/1913
Título: | Endoscopic treatment of bleeding gastric varices with histoacryl (N-butyl-2-cyanoacrylate): a South European single center experience |
Autor: | Monsanto, P Almeida, N Rosa, A Maçôas, F Lérias, C Portela, F Amaro, P Ferreira, MC Gouveia, H Sofia, C |
Palavras-chave: | Enbucrilate Endoscopia Gastrointestinal Hemorragia Gastrointestinal Escleroterapia Hemostase Endoscópica Varizes Esofágicas e Gástricas |
Data: | Jul-2013 |
Citação: | Indian J Gastroenterol. 2013 Jul;32(4):227-31. |
Resumo: | BACKGROUND: Endoscopic injection of N-butyl-2-cyanoacrylate is the current recommended treatment for gastric variceal bleeding. Despite the extensive worldwide use, there are still differences related to the technique, safety, and long term-results. We retrospectively evaluated the efficacy and safety of cyanoacrylate in patients with gastric variceal bleeding. PATIENTS AND METHODS: Between January 1998 and January 2010, 97 patients with gastric variceal bleeding underwent endoscopic treatment with a mixture of N-butyl-2-cyanoacrylate and Lipiodol(TM). Ninety-one patients had cirrhosis and 6 had non-cirrhotic portal hypertension. Child-Pugh score at presentation for cirrhotic patients was A-12.1 %; B-53.8 %; C-34.1 % and median MELD score at admission was 13 (3-26). Successful hemostasis, rebleeding rate and complications were reviewed. Median time of follow up was 19 months (0.5-126). RESULTS: A median mixture volume of 1.5 mL (0.6 to 5 mL), in 1 to 8 injections, was used, with immediate hemostasis rate of 95.9 % and early rebleeding rate of 14.4 %. One or more complications occurred in 17.5 % and were associated with the use of Sengstaken-Blakemore tube before cyanoacrylate and very early rebleeding (p < 0.05). Hospital mortality rate during initial bleeding episode was 9.3 %. Very early rebleeding was a strong and independent predictor for in-hospital mortality (p < 0.001). Long-term mortality rate was 58.8 %, in most of the cases secondary to hepatic failure. CONCLUSION: N-butyl-2-cyanoacrylate is a rapid, easy and highly effective modality for immediate hemostasis of gastric variceal bleeding with an acceptable rebleeding rate. Patients with very early rebleeding are at higher risk of death. |
Peer review: | yes |
URI: | http://hdl.handle.net/10400.4/1913 |
DOI: | 10.1007/s12664-012-0191-3 |
Aparece nas colecções: | GAS - Artigos |
Ficheiros deste registo:
Ficheiro | Descrição | Tamanho | Formato | |
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Endoscopic treatment of bleeding gastric varices.pdf | 116,73 kB | Adobe PDF | Ver/Abrir |
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