title: Proton pump inhibitor administration delays rebleeding after endoscopic gastric variceal obturation.
abstract: OBJECTIVE
  To clarify the efficacy of proton pump inhibitors (PPIs) after endoscopic variceal obturation (EVO) with N-butyl-2-cyanoacrylate.
  
  
  METHODS
  A retrospective study was performed on 16 liver cirrhosis patients with gastric variceal bleeding that received EVO with injections of N-butyl-2-cyanoacrylate at a single center (Kyung Hee University Hospital at Gangdong) from January 2008 to December 2012. Medical records including patient characteristics and endoscopic findings were reviewed. Treatment results, liver function, serum biochemistry and cirrhosis etiology were compared between patients receiving PPIs and those that did not. Furthermore, the rebleeding interval was compared between patients that received PPI treatment after EVO and those who did not.
  
  
  RESULTS
  The patient group included nine males and seven females with a mean age of 61.8 ± 11.7 years. Following the EVO procedure, eight of the 12 patients that received PPIs and three of the four non-PPI patients experienced rebleeding. There were no differences between the groups in serum biochemistry or patient characteristics. The rebleeding rate was not significantly different between the groups, however, patients receiving PPIs had a significantly longer rebleeding interval compared to non-PPI patients (22.2 ± 11.2 mo vs 8.5 ± 5.5 mo; P = 0.008). The duration of PPI use was not related to the rebleeding interval. A total of six patients, who had ulcers at the injection site, exhibited a shorter rebleeding interval (16.8 ± 5.9 mo) than patients without ulcers (19.9 ± 3.2 mo), though this difference was not statistically significant.
  
  
  CONCLUSIONS
  PPI therapy can extend the rebleeding interval, and should therefore be considered after EVO treatment for gastric varices.
authors.affiliation: Won Seok Jang, Hyun Phil Shin, Joung Il Lee, Kwang Ro Joo, Jae Myung Cha, Jung Won Jeon, Jun Uk Lim, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul 130-701, South Korea.
authors.forename: Won Seok
authors.initials: WS
authors.lastname: Jang
authors.affiliation: Won Seok Jang, Hyun Phil Shin, Joung Il Lee, Kwang Ro Joo, Jae Myung Cha, Jung Won Jeon, Jun Uk Lim, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul 130-701, South Korea.
authors.forename: Hyun Phil
authors.initials: HP
authors.lastname: Shin
authors.affiliation: Won Seok Jang, Hyun Phil Shin, Joung Il Lee, Kwang Ro Joo, Jae Myung Cha, Jung Won Jeon, Jun Uk Lim, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul 130-701, South Korea.
authors.forename: Joung Il
authors.initials: JI
authors.lastname: Lee
authors.affiliation: Won Seok Jang, Hyun Phil Shin, Joung Il Lee, Kwang Ro Joo, Jae Myung Cha, Jung Won Jeon, Jun Uk Lim, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul 130-701, South Korea.
authors.forename: Kwang Ro
authors.initials: KR
authors.lastname: Joo
authors.affiliation: Won Seok Jang, Hyun Phil Shin, Joung Il Lee, Kwang Ro Joo, Jae Myung Cha, Jung Won Jeon, Jun Uk Lim, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul 130-701, South Korea.
authors.forename: Jae Myung
authors.initials: JM
authors.lastname: Cha
authors.affiliation: Won Seok Jang, Hyun Phil Shin, Joung Il Lee, Kwang Ro Joo, Jae Myung Cha, Jung Won Jeon, Jun Uk Lim, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul 130-701, South Korea.
authors.forename: Jung Won
authors.initials: JW
authors.lastname: Jeon
authors.affiliation: Won Seok Jang, Hyun Phil Shin, Joung Il Lee, Kwang Ro Joo, Jae Myung Cha, Jung Won Jeon, Jun Uk Lim, Department of Internal Medicine, College of Medicine, Kyung Hee University, Seoul 130-701, South Korea.
authors.forename: Jun Uk
authors.initials: JU
authors.lastname: Lim
mesh_terms: D000368:Aged; D004334:Drug Administration Schedule; D004659:Enbucrilate / Q000009:adverse effects / Q000627:therapeutic use*; D004932:Esophageal and Gastric Varices / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000009:adverse effects / Q000379:methods*; D006785:Hospitals, University; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D012008:Recurrence; D056910:Republic of Korea; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors; D004659:Enbucrilate
keywords: Cirrhosis; Endoscopic variceal obturation; N-butyl-2-cyanoacrylate; Proton pump inhibitor; Rebleeding interval