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Endoscopic N-butyl-2-cyanoacrylate and ethanolamine oleate injection is equivalent to balloon-occluded retrograde transvenous obliteration for preventing gastric variceal bleeding

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Abstract

Objectives

Endoscopic injection sclerotherapy (EIS) is effective for temporary hemostasis, but EIS and balloon-occluded retrograde transvenous obliteration (BRTO) have been reported as effective for secondary prophylaxis of gastric varices (GV) bleeding. This study retrospectively compared EIS and BRTO in patients with GV in terms of the efficacy for secondary prevention of GV bleeding and effects on liver function.

Methods

From our database of patients with GV who underwent EIS or BRTO between February 2011 and April 2020, a total of 42 patients with GV were retrospectively enrolled. The primary endpoint was the bleeding rate from GV, which was compared between EIS and BRTO groups. Secondary endpoints were liver function after treatment and rebleeding rate from EV, compared between EIS and BRTO groups. Rebleeding rates from GV and EV and liver function after treatment were also compared between EIS–ethanolamine oleate (EO)/histoacryl (HA) and EIS–HA groups.

Results

Technical success was achieved for all EIS cases, but two cases were unsuccessful in the BRTO group and underwent additional EIS. No significant differences in bleeding rates or endoscopic findings for GV improvement were seen between EIS and BRTO groups. Liver function also showed no significant difference in the amount of change after treatment between groups.

Conclusion

EIS therapy appears effective for GV in terms of preventing GV rebleeding and effects on liver function after treatment. EIS appears to represent an effective treatment for GV.

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Acknowledgements

We wish to thank all members of the Second Department of Internal Medicine at Wakayama Medical University.

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Authors and Affiliations

  1. Second Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama-shi, Wakayama, 641-0012, Japan

    Shinya Taki, Mikitaka Iguchi, Takao Maekita, Jun Kinoshita, Masaki Takao & Masayuki Kitano

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  1. Shinya Taki
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  2. Mikitaka Iguchi
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  3. Takao Maekita
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  4. Jun Kinoshita
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  5. Masaki Takao
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  6. Masayuki Kitano
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Contributions

MI wrote the manuscript. MT, JK, and TM treated the patients and analyzed the data. MK checked the manuscript.

Corresponding author

Correspondence to Mikitaka Iguchi.

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Disclosures

Shinya Taki, Mikitaka Iguchi, Takao Maekita, Jun Kinoshita, Masaki Takao, and Masayuki Kitano have no conflicts of interest for this article.

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Taki, S., Iguchi, M., Maekita, T. et al. Endoscopic N-butyl-2-cyanoacrylate and ethanolamine oleate injection is equivalent to balloon-occluded retrograde transvenous obliteration for preventing gastric variceal bleeding. Surg Endosc 37, 6008–6014 (2023). https://doi.org/10.1007/s00464-023-10064-3

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  • DOI: https://doi.org/10.1007/s00464-023-10064-3

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