Chinese Hepatolgy ›› 2023, Vol. 28 ›› Issue (8): 912-915.

• Liver Fibrosis & Cirrhosis • Previous Articles     Next Articles

Efficacy of endoscopic titanium clip combined with cyanoacrylate injection in the treatment of gastric varices

XI Liang1, QUAN Xing-pu1, WANG Xiao-wei2, WANG Yun1, QIU He1, XU Jun-wang1   

  1. 1. Department of Gastroenterology, the First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi 710061, China;
    2. Department of Gynecologic Neoplasms, Cancer Hospital of Shaanxi Province, Shaanxi 710061, China
  • Received:2022-09-29 Online:2023-08-31 Published:2023-09-21
  • Contact: XU Jun-wang,Emali:xujwdoctor@aliyun.com

PDF (PC)

91

Abstract: Objective To investigate the clinical efficacy of endoscopic metal titanium clip combined with cyanoacrylate injection on GOV1, GOV2, IGV1 gastric varices.Methods Retrospective analysis of 150 patients with gastric varices of GOV1, GOV2 and IGV1 who were hospitalized in the First Affiliated Hospital of Xi'an Jiaotong University from January 1, 2017 to December 31, 2020. According to the treatment plan, it was divided into a control group (cyanoacrylate treatment, 105 cases) and an observation group (titanium clip combined cyanoacrylate treatment, 45 cases). The clinical efficacy, rebleed rate and complications of the two groups were compared and analyzed. Follow-up treatment was performed at 0, 1, 3, and 6 months, for a total of 10 months.Results The gastric / splenorenal shunt rate in the observation group was 22.2%, which was significantly higher than 0% in the control group (0%) (P<0.001); the number of gastric varices in the observation group was 3 (3, 3), which was significantly higher than 3 (2, 3) in the control group (P=0.028); the average cyanoacrylate dosage in the observation group was 3.29±1.0 mL, which was significantly lower than 4.11±1.51 mL in the control group (P=0.020); the rebleeding rate in the observation group was 11.1%, significantly lower than 27.6% in the control group(P=0.027). There was no significant difference between the two groups in the number of endoscopic treatment, injection points of cyanoacrylate, effective rate, varicose eradication / basic disappearance rate, postoperative sternal pain and fever (P>0.05). No serious complications such as bacteremia and ectopic embolism occurred in the two groups.Conclusion Titanium clip combined with cyanoacrylate injection therapy can reduce the amount of tissue glue, reduce the incidence of postoperative rebleeding, and may block the occurrence of ectopic embolism in gastric/spleen-kidney shunts. It is an effective treatment for gastric varices of GOV1, GOV2 and IGV1.

Key words: Titanium clip, Cyanoacrylate injection, Gastric/splenorenal shunt, Therapeutic effect, Ectopic embolism