Comparison of Histoacryl® plus Lipiodol® versus Histoacryl® plus vitamin D3 in the management of isolated fundal varices: A retrospective comparative study

Abstract

Objective: According to recent guidelines Histoacryl® (N-butyl-2 -Cyanoacrylate) injection is the first line therapy for the endoscopic obliteration of gastric varices. Lipiodol is commonly used to facilitate injection Histoacryl® but it is expensive. In this study we compare Lipiodol with Vitamin D3 injection as priming agents for Histoacryl injection in terms of efficacy and safety in the management of isolated fundal varices.
 Methods: This is a retrospective comparative study conducted at Gastroenterology Unit, Lady Reading hospital Peshawar. Patients’ information was collected from March, 2012 to January, 2020 from medical records and statistically analyzed in terms of fundal varices obliteration, re-bleeding, mortality, and adverse events related to treatment.
 Results: From March, 2012 to January, 2020, 171 patients met the criteria. 7 cases lost follow up, and all the cases in both groups were treated successfully. There were no adverse events related to procedure in either group. Twenty six patients developed upper GI re-bleeding, which did not differ significantly betweenthe twogroups. There was also no difference between the groups in terms of treatment failure, complications, varices obliteration, and mortality.
 Conclusion: Vitamin D3 is as safe and effective as Lipoidol when used as priming agent for Histoacryl injection for obliteration of isolated fundal varices and can be used as a cheaper alternative to Lipoidol.