Low incidence of complications from endoscopic gastric variceal obturation with butyl cyanoacrylate.
OBJECTIVE
Endoscopic variceal obturation with tissue adhesive is used to control gastric variceal bleeding. We investigated the prevalence of serious complications from this therapy.


METHODS
We performed a retrospective analysis of complications that occurred in 753 patients with gastric variceal hemorrhages who were hospitalized in 2 tertiary referral hospitals. All patients received N-butyl-2-cyanoacrylate as therapy for endoscopic variceal obturation.


RESULTS
Complications occurred in 51 patients. Thirty-three patients experienced rebleeding because of early-onset (within 3 months) extrusion of the N-butyl-2-cyanoacrylate glue cast (4.4%), 10 patients developed sepsis (1.3%), and 5 patients developed distant embolisms (0.7%; 1 pulmonary, 1 brain, and 3 splenic). One patient had major gastric variceal bleeding after endoscopic variceal obturation (0.1%), 1 developed a large gastric ulcer (0.1%), and 1 had mesentery hematoma, hemoperitoneum, and infection in the abdominal cavity (0.1%). The complication-related mortality was 0.53% (3 deaths from sepsis and 1 death from rebleeding after early-onset glue cast extrusion).


CONCLUSIONS
The occurrence of complications after endoscopic variceal obturation with N-butyl-2-cyanoacrylate in gastric varices treatment is rare.
Cheng
Liu-Fang
LF
Department of Gastroenterology and Hepatology, Chinese People's Liberation Army General Hospital, Beijing, China.
Wang
Zhi-Qiang
ZQ
Li
Chang-Zheng
CZ
Lin
Wu
W
Yeo
Anthony E T
AE
Jin
Bo
B
D004617:Embolism / Q000453:epidemiology; D004659:Enbucrilate / Q000009:adverse effects* / Q000627:therapeutic use; D004724:Endoscopy / Q000009:adverse effects*; D004932:Esophageal and Gastric Varices / Q000601:surgery*; D005260:Female; D006465:Hemoperitoneum / Q000453:epidemiology; D006470:Hemorrhage / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology; D013276:Stomach Ulcer / Q000453:epidemiology; D014014:Tissue Adhesives / Q000009:adverse effects* / Q000627:therapeutic use
D014014:Tissue Adhesives; D004659:Enbucrilate