Safety and efficacy of modified endoscopic ultrasound-guided selective N-butyl-2-cyanoacrylate injections for gastric variceal hemorrhage in left-sided portal hypertension  

作　　者：Yan Zeng Jian Yang Jun-Wen Zhang 

机构地区：[1]Department of Psychology,The Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China [2]Department of Gastroenterology,Changdu People's Hospital of Xizang,Changdu 854000,Tibet Autonomous Region,China [3]Department of Gastroenterology,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China

出　　处：《World Journal of Gastrointestinal Endoscopy》2024年第1期29-36,共8页世界胃肠内镜杂志（英文版）（电子版）

基　　金：Program for Youth Innovation in Future Medicine,Chongqing Medical University,China,No.W0138.

摘　　要：BACKGROUND Gastric variceal hemorrhage is one of the primary manifestations of left-sided portal hypertension(LSPH).The hemorrhage is fatal and requires safe and effective interventions.AIM To evaluate the clinical safety and efficacy of modified endoscopic ultrasound(EUS)-guided selective N-butyl-2-cyanoacrylate(NBC)injections for gastric variceal hemorrhage in LSPH.METHODS A retrospective observational study of patients with LSPH-induced gastric variceal hemorrhage was conducted.Preoperative EUS evaluations were performed.Enrolled patients were divided into modified and conventional groups according to the NBC injection technique.The final selection of NBC injection technique depended on the patients’preferences and clinical status.The technical and clinical success rates,operation time,NBC doses,perioperative complications,postoperative hospital stay,and recurrent bleeding rates were analyzed,respectively.RESULTS A total of 27 patients were enrolled.No statistically significant differences were observed between the two groups regarding baseline characteristics.In comparison to patients in the conventional group,patients in the modified group demonstrated significantly reduced NBC doses(2.0±0.6 mL vs 3.1±1.0 mL;P=0.004)and increased endoscopic operation time(71.9±11.9 min vs 22.5±6.7 min;P<0.001).Meanwhile,the two groups had no significant difference in the technical and clinical success rates,perioperative complications,postoperative hospital stay,and recurrent bleeding rates.CONCLUSION Modified EUS-guided selective NBC injections demonstrated safety and efficacy for LSPH-induced gastric variceal hemorrhage,with advantages of reduced injection dose and no radiation risk.Drawbacks were time consumption and technical challenge.

关 键 词：Endoscopic ultrasound SELECTIVE N-butyl-2-cyanoacrylate Gastric varices Hemorrhage Left-sided portal hypertension 

分 类 号：R573[医药卫生—消化系统]