title: A retrospective comparative study of histoacryl injection and banding ligation in the treatment of acute type 1 gastric variceal hemorrhage.
abstract: BACKGROUND. Esophageal varices extending along lesser curvature side of stomach is classified as GOV1. The optimal therapy for GOV1 bleeding is still undetermined. METHODS. One hundred and sixty-two patients diagnosed as acute hemorrhage from GOV1 were enrolled. At endoscopists' discretion, 118 patients received glue injection (Glue group) and 44 patients received ligation to arrest bleeding [endoscopic variceal ligation (EVL) group]. This study aimed to compare hemostasis, rebleeding, complications and mortality within 42 days. RESULTS. Both groups were comparable in baseline data. In 109 patients (92%) in the Glue group and 36 patients (82%) in the EVL group (p = 0.07) 48-h hemostasis was achieved . Hemostasis of active bleeding was achieved in 49 of 55 patients (89%) in the Glue group and 24 of 28 patients (85%) in the EVL group (p = 0.70). Treatment failure was noted in 14% of the Glue group and 23% in the EVL group (p = 0.22). Eight patients in the Glue group and four patients in the EVL group rebled between 5 and 42 days (p = 0.73). A total of 48 and 19 adverse events occurred in the Glue and EVL groups, respectively (p = 0.85). Six patients in the Glue group and seven patients in the EVL group encountered posttreatment gastric ulcer bleeding (p = 0.04). Seventeen patients (14%) in the Glue group and 10 (23%) patients in the EVL group died within 42 days (p < 0.001). CONCLUSIONS. Banding ligation was similar to glue injection in achieving successful hemostasis of acute bleeding from GOV1. However, a higher incidence of posttreatment ulcer bleeding and mortality may be associated with banding ligation.
authors.affiliation: Department of Medical Research.
authors.forename: Gin-Ho
authors.initials: GH
authors.lastname: Lo
authors.forename: Chih-Wen
authors.initials: CW
authors.lastname: Lin
authors.forename: Daw-Shyong
authors.initials: DS
authors.lastname: Perng
authors.forename: Chi-Yang
authors.initials: CY
authors.lastname: Chang
authors.forename: Ching-Tai
authors.initials: CT
authors.lastname: Lee
authors.forename: Chuan-Yuan
authors.initials: CY
authors.lastname: Hsu
authors.forename: Huay-Min
authors.initials: HM
authors.lastname: Wang
authors.forename: Hui-Chen
authors.initials: HC
authors.lastname: Lin
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004659:Enbucrilate / Q000627:therapeutic use*; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D015552:Injections, Intralesional; D053208:Kaplan-Meier Estimate; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D004659:Enbucrilate