Procedure-related complications in gastric variceal obturation with tissue glue

作     者：Yun-Wei Guo Hui-Biao Miao Zhuo-Fu Wen Jie-Ying Xuan Hao-Xiong Zhou 

作者机构：Department of Gastroenterologythe Third Affiliated Hospital of Sun Yat-Sen University 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2017年第23卷第43期

页      面：7746-7755页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：Supported by Guangdong Science and Technology Program No.2016A020216012 

主　　题：Endoscopic gastric variceal obturation Tissue glue N-butyl-2-cyanoacrylate Complications 

摘      要：AIM To focus on procedure-related complications,evaluate their incidence,analyze the reasons and discuss the *** Overall,628 endoscopic gastric variceal obturation(EGVO) procedures(case-times) with NBC were performed in 519 patients in the Department of Endoscopy of the Third Affiliated Hospital of Sun Yat-Sen University from January 2011 to December 2016. The clinical data of patients and procedure-related complications of EGVO were retrospectively *** In the 628 EGVO procedures,sticking of the needle to the varix occurred in 9 cases(1.43%),including 1 case that used lipiodol-diluted NBC and 8 cases that used undiluted NBC(P = 0.000). The needle was successfully withdrawn in 8 cases. Large spurt bleeding occurred in one case,and hemostasis was achieved by two other injections of undiluted glue. The injection catheter became blocked in 17 cases(2.71%) just during the injection,and 4 cases were complicated with the needle sticking to the varix. Large glue adhesion to the endoscope resulted in difficulty withdrawing the endoscope in 1 case. Bleeding from multiple sites was observed in the esophagus and gastric cardia after the endoscope was withdrawn. Hemostasis was achieved by 1% aethoxysklerol injection and intravenous somatostatin. The ligation device stuck to the varices in two cases during the subsequent endoscopic variceal ligation. In one case,the ligation device was successfully separated from the esophageal varix after all bands were released. In another case,a laceration of the vein and massive bleeding were observed. The bleeding ceased after 1% aethoxysklerol *** Although EGVO with tissue glue is usually safe and effective,a series of complications can occur during the procedure that may puzzle endoscopists. There is no standard operating procedure for addressing these complications. The cases described in the current study can provide some reference for others.