Prophylactic cyanoacrylate injection for gastric extension of esophageal varices: a randomized controlled trial

Metwally, Mohamed A.; El-Shewi, Mohammed E; El-Ghaffar, Mohammad M Abd; Ahmed, Ayman R; Seleem, Shaimaa I

doi:10.5114/ceh.2022.114271

Cited by 2 publications

(1 citation statement)

References 25 publications

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“…GOV1 represents an extension of EV and is also a supply vessel for EV. EV ligation is considered the standard treatment, with ECI and lauromacrogol reported in previous studies [10]. A prior study comparing ligation and ECI found that ligation was superior to cyanoacrylate injection in reducing the long-term rebleeding rate in GOV I [11].…”

Section: Discussionmentioning

confidence: 99%

Gastric variceal obstruction improves the efficacy of endoscopic management of esophageal variceal bleeding in GOV type I

Huang,

Zou,

Wang

et al. 2024

Endosc Int Open

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Background and study aims Limited data exist regarding endoscopic obstruction of type I gastroesophageal (GOV I) in managing bleeding from esophageal varices. In this multicenter retrospective cohort study, we aimed to access the efficacy of blocking gastric varices in management of bleeding from esophageal varices in patients with GOV1. Patients and methods Cirrhotic patients experiencing bleeding from esophageal varices and having GOV I gastric varices in four centers were screened. All included patients were followed up for 180 days, or until death. Results A total of 93 cirrhotic patients with GOV I and bleeding esophageal varices were included. Among them, 58 patients underwent endoscopic cyanoacrylate injection (ECI) for gastric varices in addition to treatment for esophageal varices (EV), while the remaining 35 patients received treatment for EV only. Kaplan-Meier analysis demonstrated that the cumulative 180-day rebleeding rate was significantly lower in the ECI plus EV treatment group (7.9%) compared with the EV treatment group (30.7%) (P = 0.0031). The cumulative incidence of 180-day mortality was 1.9% in the ECI plus EV treatment group and 23.9% in the EV treatment group (P = 0.0010). Multivariable Cox regression analysis revealed that concomitant ECI treatment was an independent protective factor against 180-day rebleeding and overall mortality. Conclusions In conclusion, obstruction of gastric varices in addition to endoscopic treatment for bleeding from esophageal varices in patients with GOV 1 proved superior to endoscopic treatment alone for esophageal variceal bleeding.

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Section: Discussionmentioning

confidence: 99%

Gastric variceal obstruction improves the efficacy of endoscopic management of esophageal variceal bleeding in GOV type I

Huang,

Zou,

Wang

et al. 2024

Endosc Int Open

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Non-selective beta-blockers and the incidence of hepatocellular carcinoma in patients with cirrhosis: a meta-analysis

Zhao

Jiang

et al. 2023

Front. Pharmacol.

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Background: Hepatocellular carcinoma (HCC) is a serious complication of cirrhosis. Currently, non-selective beta-blockers (NSBBs) are commonly used to treat portal hypertension in patients with cirrhosis. The latest research shows that NSBBs can induce apoptosis and S-phase arrest in liver cancer cells and inhibit the development of hepatic vascular endothelial cells, which may be effective in preventing HCC in cirrhosis patients.Aim: To determine the relationship between different NSBBs and HCC incidence in patients with cirrhosis.Methods: We searched the Cochrane database, MEDLINE, EMBASE, PubMed, and Web of Science. Cohort studies, case‒control studies, and randomized controlled trials were included if they involved cirrhosis patients who were divided into an experimental group using NSBBs and a control group with any intervention. Based on heterogeneity, we calculated odds ratio (OR) and 95% confidence interval (CI) using random-effect models. We also conducted subgroup analysis to explore the source of heterogeneity. Sensitivity analysis and publication bias detection were performed.Results: A total of 47 studies included 38 reporting HCC incidence, 26 reporting HCC-related mortality, and 39 reporting overall mortality. The HCC incidence between the experimental group and the control group was OR = 0.87 (0.69 and 1.10), p = 0.000, and I2 = 81.8%. There was no significant association between propranolol (OR = 0.94 and 95%CI 0.62–1.44) or timolol (OR = 1.32 and 95%CI 0.44–3.95) and HCC incidence, while the risk of HCC decreased by 26% and 38% with nadolol (OR = 0.74 and 95%CI 0.64–0.86) and carvedilol (OR = 0.62 and 95%CI 0.52–0.74), respectively.Conclusion: Different types of NSBB have different effects on the incidence of patients with cirrhosis of the liver, where nadolol and carvedilol can reduce the risk. Also, the effect of NSBBs may vary in ethnicity. Propranolol can reduce HCC incidence in Europe and America.Systematic Review Registration: identifier https://CRD42023434175, https://www.crd.york.ac.uk/PROSPERO/.

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Prophylactic cyanoacrylate injection for gastric extension of esophageal varices: a randomized controlled trial

Cited by 2 publications

References 25 publications

Gastric variceal obstruction improves the efficacy of endoscopic management of esophageal variceal bleeding in GOV type I

Gastric variceal obstruction improves the efficacy of endoscopic management of esophageal variceal bleeding in GOV type I

Non-selective beta-blockers and the incidence of hepatocellular carcinoma in patients with cirrhosis: a meta-analysis

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