Pre-injection of lauromacrogol decreases rebleeding due to cyanoacrylate extrusion after cyanoacrylate injection of gastric varices

doi:10.3877/cma.j.issn.2095-7157.2018.02.006

Abstract

Abstract:

Objective

The rate of early rebleeding was evaluated due to early cyanoacrylate extrusion after pre-injection of lauromacrogol before cyanoacrylate injection for treating gastric varices.

Method

A total of 274 patients admitted to the digestive endoscopic center of PLA Rocket Force General Hospital for gastric varices between January 2014 and March 2018 were enrolled into two treatment groups: lauromacrogol-cyanoacrylate group and cyanoacrylate group. Patients were followed up to observe early rebleeding due to cyanoacrylate extrusion.

Results

In the cyanoacylate group, 9 of 133 patients developed rebleeding due to cyanoacrylate extrusion, the rebleeding rate was 6.8%.While in the lauromacrogol- cyanoacrylate group, only 2 of 144 patients developed rebleeding due to cyanoacrylate extrusion, the rebleeding rate was 1.4%, lower than that of cyanoacrylate group (P=0.031).

Conclusion

In this study, it was demonstrated that pretreated with lauromacrogol before cyanoacrylate injection can significantly decrease the rebleeding rate due to cyanoacrylate extrusion.

Key words: Gastric varices, Endoscopic cyanoacrylate injection, Early rebleeding due to cyanoacrylate extrusion, Pre-injection of lauromacrogol

Changzheng Li, Wenwei Hu, Xue Li, Dan Zhang, Jing Xie, Chaoyong Sun. Pre-injection of lauromacrogol decreases rebleeding due to cyanoacrylate extrusion after cyanoacrylate injection of gastric varices[J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2018, 05(02): 74-77.

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References 15

[1]	中华医学会肝病学分会，中华医学会消化病学分会，中华医学会内镜学分会．肝硬化门静脉高压食管胃静脉曲张出血防治指南(2015) [J/CD]．中华胃肠内镜电子杂志，2015，2(4):1-21.
[2]	中华医学会消化病学分会，中华医学会肝病学分会，中华医学会内镜学分会．肝硬化门静脉高压食管胃静脉曲张出血的防治共识(2008，杭州) [J]．内科理论与实践，2009，4(2):152-158.
[3]	Cheng LF，Wang ZQ，Li CZ，et al.Low incidence of complications from endoscopic gastric variceal obturation with butyl cyanoacrylate[J]. Clin Gastroenterol Hepatol，2010，8(9):760-766.
[4]	Wang YM，Cheng LF，Li N，et al.Study of glue extrusion after endoscopic N-butyl-2-cyanoacrylate injection on gastric variceal bleeding[J]．World J Gastroenterol，2009，15(39):4945-4951.
[5]	Kang EJ，Jeong SW，Jang JY，et al.Long-term result of endoscopic Histoacryl (N-butyl-2-cyanoacrylate) injection for treatment of gastric varices[J]．World J Gastroenterol，2011，17(11):1494-1500.
[6]	Nakayama S，Murashima N．Extrusion of Glue Cast after Sclerotherapy[J]．Intern Med，2015，54(21):2781.
[7]	侯运萌，向慧玲．组织胶联合聚桂醇治疗胃底静脉曲张出血的排胶规律研究[J]．中国内镜杂志，2015，21(7):673-679.
[8]	程留芳，王志强，令狐恩强，等．经内镜注射组织粘合剂治疗食管胃静脉曲张[J]．中华消化内镜杂志，1999，16(2):88-90.
[9]	中华医学会消化内镜学分会食管胃静脉曲张学组．消化道静脉曲张及出血的内镜诊断和治疗规范试行方案(2009年) [J]．中华消化内镜杂志，2010，27(1):1-7.
[10]	Soehendra N，Nam VC，Grimm H，et al.Endoscopic obliteration of large oesophageal gastric varices with bucrylate[J]．Endoscopy，1986，18(1):1825-1826.
[11]	Weilert F，Binmoeller KF. Endoscopic management of gastric variceal bleeding[J]．Gastroenterol Clin North Am，2014，43(4):807-818.
[12]	Cheng LF, Wang ZQ, Li CZ，et al.Treatment of gastric varices by endoscopic sclerotherapy using butyl cyanoacrylate: 10 years′ experience of 635 cases[J]．Chin Med J (Engl)，2007，120(23):2081-2085.
[13]	令狐恩强．食管胃静脉曲张破裂出血的防治进展(2015年)指南解读[J/CD]．中华胃肠内镜电子杂志，2015，2(4):22-24.
[14]	Maruyama H，Okabe S，Ishihara T，et al.Long-term effect of endoscopic injection therapy with combined cyanoacrylate and ethanol for gastric fundal varices in relation to portal hemodynamics[J]．Abdom Imaging，2010，35(1):8-14.
[15]	Zeng XQ，Ma LL，Tseng YJ，et al.Endoscopic cyanoacrylate injection with or without lauromacrogol for gastric varices：A randomized pilot study[J]．J Gastroenterol Hepatol，2017，32(3):631-638.

项目	改良方法组(n＝141)	传统方法组(n＝133)	P值
性别(男/女)	99/42	95/38	0.894
年龄(岁)	51.8±10.3	52.3±10.6	0.438
Child-Pugh评分	8.2±2.4	8.1±2.5	0.883
病因(乙肝/酒精肝)	98/43	94/39	0.895
治疗前超声门静脉直径(mm)	11.8±2.5	12.1±2.4	0.632

项目	改良方法组(n＝141)	传统方法组(n＝133)	P值
性别(男/女)	99/42	95/38	0.894
年龄(岁)	51.8±10.3	52.3±10.6	0.438
Child-Pugh评分	8.2±2.4	8.1±2.5	0.883
病因(乙肝/酒精肝)	98/43	94/39	0.895
治疗前超声门静脉直径(mm)	11.8±2.5	12.1±2.4	0.632

项目	改良方法组(n＝141)	传统方法组(n＝133)	P值
胃静脉曲张直径(D1.0/D1.5/D2.0/D3.0)，例	10/78/33/20	9/75/31/18	0.997
食管静脉曲张位置(Ls/Lm/Li)，例	81/45/15	79/39/15	0.896
食管静脉曲张直径(D1.0/D1.5/D2.0)，例	43/88/10	38/84/11	0.898

项目	改良方法组(n＝141)	传统方法组(n＝133)	P值
胃静脉曲张直径(D1.0/D1.5/D2.0/D3.0)，例	10/78/33/20	9/75/31/18	0.997
食管静脉曲张位置(Ls/Lm/Li)，例	81/45/15	79/39/15	0.896
食管静脉曲张直径(D1.0/D1.5/D2.0)，例	43/88/10	38/84/11	0.898

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