Results of treatment of esophageal variceal hemorrhage with endoscopic injection of n-butyl-2-cyanoacrylate in patients with Child-Pugh class C cirrhosis
Background and study aims: The results of endoscopic treatment with elastic band ligation for esophageal variceal bleeding in patients with Child-Pugh class C cirrhosis remain poor. In comparison with treatment with elastic band ligation, we have found lower rates of rebleeding and mortality with n-...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2015-08-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1392600 |
| _version_ | 1819012204977979392 |
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| author | Joao Paulo Ribeiro Sérgio Eiji Matuguma Spencer Cheng Paulo Herman Paulo Sakai Luiz Augusto Carneiro D'Albuquerque Fauze Maluf-Filho |
| author_facet | Joao Paulo Ribeiro Sérgio Eiji Matuguma Spencer Cheng Paulo Herman Paulo Sakai Luiz Augusto Carneiro D'Albuquerque Fauze Maluf-Filho |
| author_sort | Joao Paulo Ribeiro |
| collection | DOAJ |
| description | Background and study aims: The results of endoscopic treatment with elastic band ligation for esophageal variceal bleeding in patients with Child-Pugh class C cirrhosis remain poor. In comparison with treatment with elastic band ligation, we have found lower rates of rebleeding and mortality with n-butyl-2-cyanoacrylate injections. Thus, the aim of the current study was to describe our unit’s 10 years of experience with injection of n-butyl-2-cyanoacrylate to control esophageal variceal ruptures in patients with Child-Pugh class C cirrhosis.
Patients and methods: A single-center, retrospective study was conducted. Sixty-three patients with Child-Pugh class C cirrhosis had been admitted to the center with an acute episode of esophageal variceal bleeding. All were treated with injection of n-butyl-2-cyanoacrylate. The patients were assigned to 1 of 2 groups according to their Child-Pugh class C cirrhosis scores: group I (score range, 10 through 13 points) and group II (score, 14 or 15 points). The 3 variables studied were rates of initial failure to control bleeding, failure to prevent rebleeding (secondary prophylaxis), and mortality. Patients in the 2 groups (group I, n = 50; group II, n = 13) had similar characteristics.
Results: Bleeding was successfully controlled in almost 75 % of the patients during the first 5 days after treatment, with no significant differences observed between groups I and II. There were no significant differences between the 2 groups with respect to mortality rate for the first 5 days after treatment. Thirty-four patients (54 %) were free of bleeding at 6 weeks after treatment, with a significant difference noted between the groups: group I, 64 %, versus group II, 15.4 % (P < 0.001). The overall mortality rate was 44.4 %, with a significant difference noted between the groups: group I, 34 %, versus group II, 84.6 % (P < 0.001).
Conclusion: Endoscopic injection of n-butyl-2-cyanoacrylate is a valid treatment option to control esophageal variceal bleeding in patients with a Child-Pugh class C cirrhosis score in the range of 10 through 13 points. |
| first_indexed | 2024-12-21T01:40:21Z |
| format | Article |
| id | doaj.art-d771389281d342cf8f9690d8cb761316 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-21T01:40:21Z |
| publishDate | 2015-08-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-d771389281d342cf8f9690d8cb7613162022-12-21T19:20:10ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362015-08-010306E584E58910.1055/s-0034-1392600Results of treatment of esophageal variceal hemorrhage with endoscopic injection of n-butyl-2-cyanoacrylate in patients with Child-Pugh class C cirrhosisJoao Paulo Ribeiro0Sérgio Eiji Matuguma1Spencer Cheng2Paulo Herman3Paulo Sakai4Luiz Augusto Carneiro D'Albuquerque5Fauze Maluf-Filho6Department of Gastroenterology, University of São Paulo, São Paulo, BrazilDepartment of Gastroenterology, University of São Paulo, São Paulo, BrazilDepartment of Gastroenterology, University of São Paulo, São Paulo, BrazilDepartment of Gastroenterology, University of São Paulo, São Paulo, BrazilDepartment of Gastroenterology, University of São Paulo, São Paulo, BrazilDepartment of Gastroenterology, University of São Paulo, São Paulo, BrazilDepartment of Gastroenterology, University of São Paulo, São Paulo, BrazilBackground and study aims: The results of endoscopic treatment with elastic band ligation for esophageal variceal bleeding in patients with Child-Pugh class C cirrhosis remain poor. In comparison with treatment with elastic band ligation, we have found lower rates of rebleeding and mortality with n-butyl-2-cyanoacrylate injections. Thus, the aim of the current study was to describe our unit’s 10 years of experience with injection of n-butyl-2-cyanoacrylate to control esophageal variceal ruptures in patients with Child-Pugh class C cirrhosis. Patients and methods: A single-center, retrospective study was conducted. Sixty-three patients with Child-Pugh class C cirrhosis had been admitted to the center with an acute episode of esophageal variceal bleeding. All were treated with injection of n-butyl-2-cyanoacrylate. The patients were assigned to 1 of 2 groups according to their Child-Pugh class C cirrhosis scores: group I (score range, 10 through 13 points) and group II (score, 14 or 15 points). The 3 variables studied were rates of initial failure to control bleeding, failure to prevent rebleeding (secondary prophylaxis), and mortality. Patients in the 2 groups (group I, n = 50; group II, n = 13) had similar characteristics. Results: Bleeding was successfully controlled in almost 75 % of the patients during the first 5 days after treatment, with no significant differences observed between groups I and II. There were no significant differences between the 2 groups with respect to mortality rate for the first 5 days after treatment. Thirty-four patients (54 %) were free of bleeding at 6 weeks after treatment, with a significant difference noted between the groups: group I, 64 %, versus group II, 15.4 % (P < 0.001). The overall mortality rate was 44.4 %, with a significant difference noted between the groups: group I, 34 %, versus group II, 84.6 % (P < 0.001). Conclusion: Endoscopic injection of n-butyl-2-cyanoacrylate is a valid treatment option to control esophageal variceal bleeding in patients with a Child-Pugh class C cirrhosis score in the range of 10 through 13 points.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1392600 |
| spellingShingle | Joao Paulo Ribeiro Sérgio Eiji Matuguma Spencer Cheng Paulo Herman Paulo Sakai Luiz Augusto Carneiro D'Albuquerque Fauze Maluf-Filho Results of treatment of esophageal variceal hemorrhage with endoscopic injection of n-butyl-2-cyanoacrylate in patients with Child-Pugh class C cirrhosis Endoscopy International Open |
| title | Results of treatment of esophageal variceal hemorrhage with endoscopic injection of n-butyl-2-cyanoacrylate in patients with Child-Pugh class C cirrhosis |
| title_full | Results of treatment of esophageal variceal hemorrhage with endoscopic injection of n-butyl-2-cyanoacrylate in patients with Child-Pugh class C cirrhosis |
| title_fullStr | Results of treatment of esophageal variceal hemorrhage with endoscopic injection of n-butyl-2-cyanoacrylate in patients with Child-Pugh class C cirrhosis |
| title_full_unstemmed | Results of treatment of esophageal variceal hemorrhage with endoscopic injection of n-butyl-2-cyanoacrylate in patients with Child-Pugh class C cirrhosis |
| title_short | Results of treatment of esophageal variceal hemorrhage with endoscopic injection of n-butyl-2-cyanoacrylate in patients with Child-Pugh class C cirrhosis |
| title_sort | results of treatment of esophageal variceal hemorrhage with endoscopic injection of n butyl 2 cyanoacrylate in patients with child pugh class c cirrhosis |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1392600 |
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