We report on three patients with severe recurrent bleeding from large esophagogastric varices which could not be controlled by conservative treatment or sclerotherapy. In these cases the bleeding was successfully arrested by intravascular injection of Bucrylate.

We report on our two years' experience with the tissue adhesive n-butyl-2-cyanoacrylate. During this period 202 patients suffering from esophagogastric varices were treated endoscopically. With the aid of the tissue adhesive the conventional sclerotherapy with Polidocanol 1% has been clearly improved. Problems concerning early recurrent bleeding and fundic varices are satisfactorily solved. The endoscopic hemostasis of severe variceal bleedings has become safer and surer. The overall hospital mortality of these patients has sunk from 31.5 to 17.5%. Cyanoacrylate is a very useful substance for obliterating large esophagogastric varices. However, the complete elimination of esophageal varices, which is the guarantee for a long-term freedom from recurrent bleeding, can only be achieved by using a genuine sclerosing agent.

Besides pain relief, ESWL in combination with interventional endoscopy resulted in pancreatic ductal decompression, weight gain, and improvement in quality of life in a considerable number of patients with advanced CCP.