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Cyanoacrylate injection versus band ligation for bleeding from cardiac varices along the lesser curvature of the stomach

Authors
Park S.J.Kim Y.K.Seo Y.S.Park S.W.Lee H.A.Kim T.H.Suh S.J.Jung Y.K.Kim J.H.An H.Yim H.J.Jang J.Y.Yeon J.E.Byun K.S.Um S.H.
Issue Date
2016
Publisher
Korean Association for the Study of the Liver
Keywords
Band ligation; Cyanoacrylate; Endoscopy; Liver cirrhosis; Varices
Citation
Clinical and Molecular Hepatology, v.22, no.4, pp.487 - 494
Indexed
SCOPUS
KCI
Journal Title
Clinical and Molecular Hepatology
Volume
22
Number
4
Start Page
487
End Page
494
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/7083
DOI
10.3350/cmh.2016.0050
ISSN
2287-2728
Abstract
Background/Aims: Practice guidelines recommend endoscopic band ligation (EBL) and endoscopic variceal obturation (EVO) for bleeding from esophageal varices and fundal varices, respectively. However, the optimal treatment for bleeding from cardiac varices along the lesser curvature of the stomach (GOV1) remains undefined. This retrospective study compared the efficacy between EBL and EVO for bleeding from GOV1. Methods: Patients treated by EBL or EVO via cyanoacrylate injection for bleeding from GOV1 were enrolled. Patients diagnosed with hepatocellular carcinoma or treated with endoscopic injection sclerotherapy were excluded. Results: The study included 91 patients treated for bleeding from GOV1. The mean age was 56.3±10.9 years (mean±SD), and 78 of them (85.7%) were men. Overall, 51 and 40 patients were treated with EBL and EVO, respectively. A trend for a higher hemostasis rate was noted in the EVO group (100%) than in the EBL group (82.6%, P=0.078). Varices rebled in 15 patients during follow-up. The rebleeding rate was significantly higher in the EBL group than in the EVO group (P=0.004). During follow-up, 13 patients died (11 in the EBL group and 2 in the EVO group); the survival rate was marginally significant between two groups (P=0.050). The rebleeding-free survival rate was significantly higher in the EVO group than in the EBL group (P=0.001). Conclusions: Compared to EBL, EVO offered significantly lower rebleeding rates, significantly higher rebleeding-free survival rates, and a trend for higher hemostasis and survival rates. EVO appears to be the better therapeutic option for bleeding from GOV1. © 2016 by The Korean Association for the Study of the Liver
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Anam Hospital (Department of Gastroenterology and Hepatology, Anam Hospital)
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