Revista de Gastroenterología del Perú
ISSN 1022-5129 versión impresa
CASTILLO, Ofelia, PALACIOS, Fernando, YOZA, Max et al. Uso de Cianoacrilato en la Terapia Endoscópica de Várices Gástricas: experiencia en el Hospital Nacional Edgardo Rebagliati Martins del 2006 al 2010. Rev. gastroenterol. Perú, jul./set. 2011, vol.31, no.3, p.208-215. ISSN 1022-5129.
OBJECTIVE: To evaluate the therapeutic success of the injection of N-butyl-2-cyanoacrylate in the treatment of gastric varices. METHODS: Cross-sectional study included 33 patients with gastric varices who only received cyanoacrylate endoscopic therapy between 2006 and 2010. Intravariceally, cyanoacrylate was injected in a 1:1 dilution with lipiodol until the obliteration of varices. The therapeutic situation was: active bleeding, varices with stigmata of recent bleeding and secondary prophylaxis. Treatment success was evaluated according to hemostasis, recurrent bleeding and obliteration. RESULTS: Of the 33 patients, 3 (9.1%) were for active bleeding, 20 (60.6%) with stigmata of recent bleeding and 10 (30.3%) as secondary prophylaxis. Gastric varices were GOV2, 17 (51.5%); IGV1, 14 (42.4%); GOV1, 2 (6.1%). Hemostasis was achieved in 21 (91.3%) and in 2 (66.7%) of 3 patients with active bleeding. Five (15.6%) patients had recurrent bleeding and 2 of them used cyanoacrylate with successful hemostasis. Obliteration was achieved in 25 (75.8%). Four patients died and one for failure of control bleeding. A high severity of Child-Pugh classification was related to treatment endoscopic failure (p=0.034). The main complication was bleeding after the injection of cyanoacrylate. CONCLUSIONS: Our results support the use of cyanoacrylate in the treatment of gastric varices with few major complications.
Palabras llave: Gastric varices; N-butyl-2-cyanoacrylate; endoscopic therapy.
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