Endoscopic cyanoacrylate injection with or without lauromacrogol for gastric varices: A randomized pilot study

Zeng, Xiaoqing; Ma, Lili; Tseng, Yujen; Chen, Jie; Cui, Cheng‐Bin; Luo, Tao; Wang, Jian; Chen, Shiyao

doi:10.1111/jgh.13496

Cited by 29 publications

(33 citation statements)

References 38 publications

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“…Esophageal varices (EV) were graded as follows: (i) grade 1: small, straight EV; (ii) grade 2: enlarged, tortuous EV occupying less than one‐third of the lumen; and (iii) grade 3: large, coil‐shaped EV occupying more than one‐third of the lumen. Gastric varices were defined according to previous study …”

Section: Methodsmentioning

confidence: 99%

“…To prevent tissue glue from obstructing the endoscopic channel and injection needle, the injection needle (Olympus, NM‐200L‐423, Tokyo, Japan) was exhausted with lauromacrogol before entering the endoscope. The Olympus GIF‐XQ240/260 gastroscope was used to target varicose vein for treatment using the “sandwich” technique . The needle is quickly flushed with lauromacrogol, followed by tissue adhesive (Beijing Compont Medical Devices Co., Ltd., Beijing, China) and then again by lauromacrogol .…”

Section: Methodsmentioning

confidence: 99%

“…Gastric varices were defined according to previous study. 12,13 All treatments are performed under intravenous anesthesia. Propofol (Diprivan ® ; AstraZeneca, Cheshire, UK) was administered by bolus injection according to the protocol previously reported (0.25 mg/kg with additional doses of 20-30 mg when necessary, up to a maximum dose of 120 mg).…”

Section: Methodsmentioning

confidence: 99%

“…13 The needle is quickly flushed with lauromacrogol, followed by tissue adhesive (Beijing Compont Medical Devices Co., Ltd., Beijing, China) and then again by lauromacrogol. 13 The needle sheath is held in place for a few seconds and observed for bleeding. The target vein may be supplemented with surplus tissue adhesive when necessary.…”

Section: Methodsmentioning

confidence: 99%

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Prophylactic use of antibiotics in endoscopic injection of tissue adhesive for the elective treatment of gastric varices: A randomized controlled study

Liu

Wang

et al. 2019

J of Gastro and Hepatol

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BackgroundTissue adhesive injection is the first‐line treatment for gastric varices rebleeding. Available studies are focused on antibiotic usage in emergency endoscopy, while the use of antibiotics in selective endoscopic tissue adhesive treatment remains controversial.MethodsThis is a randomized controlled study conducted in a tertiary referral hospital. Consecutive patients were enrolled from February 16, 2016, to November 19, 2016, and blindly randomized into two treatment groups. Patients in the prophylactic group received 2 g of cefotiam during endoscopic injection of tissue adhesive. All the subjects were observed for rebleeding, fever, and changes in laboratory indicators in hospital and post‐discharge.ResultOne hundred and seven patients who received endoscopic therapy for gastroesophageal varices were included. Fifty‐three patients were allocated to the antibiotic prophylactic group and 54 patients to the on‐demand group. The two groups had similar baseline characteristics. The incidence of fever in hospital was 2/53 (3.8%) vs 9/54 (16.7%) (P = 0.028). Perioperative and postoperative clinical events were significantly lower in the antibiotic prophylactic group (5.7% vs 24.1%, P = 0.018; 7.5% vs 20.4%, P = 0.050). Inflammation indices were elevated on the first day after endoscopic therapy; however, no significant difference was observed between the two groups. The cumulative rebleeding free rate within 2 months was lower in the antibiotic prophylactic group (1.9% vs 9.3%, P = 0.100).ConclusionOur study illustrated that prophylactic use of antibiotics in selective endoscopic injection of tissue adhesive reduced the incidence of the total clinical events in perioperative period and had a trend towards lower rebleeding in 2 months.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Prophylactic use of antibiotics in endoscopic injection of tissue adhesive for the elective treatment of gastric varices: A randomized controlled study

Liu

Wang

et al. 2019

J of Gastro and Hepatol

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“…Each cyanoacrylate injection point was no more than 2.0 mL and an equal volume of lipiodol or 20% glucose or 2–8 mL lauromacrogol determined by the varix size according to our published study [11]. Multiple sites injection was an attempt to completely obturate the gastric varices in one session.…”

Section: Methodsmentioning

confidence: 99%

Endoscopic Approaches to the Treatment of Variceal Hemorrhage in Hemodialysis-Dependent Patients

Huang

Zeng

et al. 2016

Gastroenterology Research and Practice

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Background. Esophagogastric variceal hemorrhage leads to challenging situation in chronic kidney disease patients on maintenance hemodialysis. Aims. To determine the safety and efficacy of endoscopic approaches to patients with hemodialysis-dependent concomitant with esophagogastric varices. Methods. Medical records were reviewed from January 1, 2004, to December 31, 2015, in our hospital. Five consecutive hemodialysis-dependent patients with variceal hemorrhage who underwent endoscopic treatments were retrospectively studied. Results. The median age of the patients was 54 years (range 34–67 years) and the median follow-up period was 21.3 months (range 7–134 months). All the patients received a total of three times heparin-free hemodialysis 24 hours before and no more than 24 hours and 72 hours after endoscopic treatment. They successfully had endoscopic variceal ligation, endoscopic injection sclerotherapy, and/or N-butyl cyanoacrylate injection. The short-term efficacy is satisfying and long-term follow-up showed episodes of rebleeding. Conclusions. Endoscopic approaches are the alternative options in the treatment of upper gastroenterology variceal hemorrhage in hemodialysis-dependent patients without severe complications.

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Secondary Prophylaxis of Variceal Bleeding in Liver Cirrhosis

Kovalic

2020

Variceal Bleeding in Liver Cirrhosis

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Endoscopic cyanoacrylate injection with or without lauromacrogol for gastric varices: A randomized pilot study

Cited by 29 publications

References 38 publications

Prophylactic use of antibiotics in endoscopic injection of tissue adhesive for the elective treatment of gastric varices: A randomized controlled study

Prophylactic use of antibiotics in endoscopic injection of tissue adhesive for the elective treatment of gastric varices: A randomized controlled study

Endoscopic Approaches to the Treatment of Variceal Hemorrhage in Hemodialysis-Dependent Patients

Secondary Prophylaxis of Variceal Bleeding in Liver Cirrhosis

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