Safety and efficacy of modified endoscopic ultrasound-guided selective N-butyl-2-cyanoacrylate injections for gastric variceal hemorrhage in left-sided portal hypertension

作者全名："Zeng, Yan; Yang, Jian; Zhang, Jun-Wen"

作者地址："[Zeng, Yan] Chongqing Med Univ, Affiliated Hosp 2, Dept Psychol, Chongqing 400010, Peoples R China; [Yang, Jian] Changdu Peoples Hosp Xizang, Dept Gastroenterol, 168 South Rd Gate, Chengdu 854000, Tibet Autonomou, Peoples R China; [Yang, Jian; Zhang, Jun-Wen] Chongqing Med Univ, Affiliated Hosp 1, Dept Gastroenterol, Chongqing 400016, Peoples R China"

通信作者："Yang, J (通讯作者)，Changdu Peoples Hosp Xizang, Dept Gastroenterol, 168 South Rd Gate, Chengdu 854000, Tibet Autonomou, Peoples R China."

来源：WORLD JOURNAL OF GASTROINTESTINAL ENDOSCOPY

ESI学科分类：　

WOS号：WOS:001156832400004

JCR分区：Q4

影响因子：2

年份：2024

卷号：16

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Endoscopic ultrasound; Selective; N-butyl-2-cyanoacrylate; Gastric varices; Hemorrhage; Left-sided portal hypertension

摘要："BACKGROUND Gastric variceal hemorrhage is one of the primary manifestations of left-sided portal hypertension (LSPH). The hemorrhage is fatal and requires safe and effective interventions. AIM To evaluate the clinical safety and efficacy of modified endoscopic ultrasound (EUS)-guided selective N-butyl-2-cyanoacrylate (NBC) injections for gastric variceal hemorrhage in LSPH. METHODS A retrospective observational study of patients with LSPH-induced gastric variceal hemorrhage was conducted. Preoperative EUS evaluations were performed. Enrolled patients were divided into modified and conventional groups according to the NBC injection technique. The final selection of NBC injection technique depended on the patients' preferences and clinical status. The technical and clinical success rates, operation time, NBC doses, perioperative complications, postoperative hospital stay, and recurrent bleeding rates were analyzed, respectively. RESULTS A total of 27 patients were enrolled. No statistically significant differences were observed between the two groups regarding baseline characteristics. In comparison to patients in the conventional group, patients in the modified group demonstrated significantly reduced NBC doses (2.0 +/- 0.6 mL vs 3.1 +/- 1.0 mL; P = 0.004) and increased endoscopic operation time (71.9 +/- 11.9 min vs 22.5 +/- 6.7 min; P < 0.001). Meanwhile, the two groups had no significant difference in the technical and clinical success rates, perioperative complications, postoperative hospital stay, and recurrent bleeding rates. CONCLUSION Modified EUS-guided selective NBC injections demonstrated safety and efficacy for LSPH-induced gastric variceal hemorrhage, with advantages of reduced injection dose and no radiation risk. Drawbacks were time consumption and technical challenge."

基金机构："Program for Youth Innovation in Future Medicine, Chongqing Medical University, China [W0138]"

基金资助正文："Supported by Program for Youth Innovation in Future Medicine, Chongqing Medical University, China, No. W0138."