SAFETY AND EFFICACY OF N-BUTYL-2-CYANOACRYLATE FOR MANAGEMENT OF GASTRIC VARICES

Authors

  • Muhammad Kabir Government category-D hospital, Badhber, Peshawar.
  • Nauman Abu Abdul Aziz Al-Rashidi Clinic, Oman
  • Shahid Fareed Government category-D hospital, Badhber, Peshawar.
  • Khalid Hameed In-charge Gastroenterology dept., Hayatabad medical complex, Peshawar.
  • Mohsin Ali Muhammad College of Medicine, Peshawar, Pakistan
  • Muhammad Arif Department of Pharmacology, AJK Medical College, Muzaffarabad, Pakistan

Keywords:

N-Butyl-2-Cyanoacrylate, Gastric varices, Efficacy, Peshawar, Pakistan

Abstract

Background: Gastric varices (GVs) bleed less frequently than oesophageal varices. Gastric variceal bleeding tends to be severe with higher mortality and re-bleed frequently after spontaneous haemostasis. This study evaluated the safety and efficacy of N-Butyl-2-Cyanoacrylate for the management of gastric varices in patients presenting to tertiary care setting. Methods: This descriptive case study was performed at Department of Gastroenterology and Hepatology, Hayatabad Medical Complex, Peshawar between Jan and July 2022. Seventy-three patients of either gender were included in the study. Screening and interventional endoscopy were done and patient were observed for efficacy and safety of N-Butyl-2-Cyanoacrylate injection. Data was analysed using SPSS-22. Results: The mean age and BMI of the patients were 54.96±2.64 years and 28.98±246 Kg/m2 respectively. There were 75.78% male and 24.21% female (M:F=31:1) patients. The aetiological cause of gastric varices was Hepatitis-B virus in 62.10%, alcohol in 23.15% and other causes in 14.73% patients. Child Pugh Class was A in 37.89% patients, B in 50.52% and C in 11.57% patients. Adequate haemostasis was achieved in 95.78% patients and re-bleeding was observed in 30.52% patients. Fever was recorded in 5.26% patients, abdominal pain in 3.15% and diarrhoea in 1.05%. Spontaneous bacterial peritonitis was not reported in any case (0.0%). Conclusion: N-Butyl-2-Cyanoacrylate is efficacious and safe for the management of gastric varices.

Pak J Physiol 2023;19(3):7–10

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References

Henry Z, Patel K, Patton H, Saad W. AGA clinical practice update on management of bleeding gastric varices: expert review. Clin Gastroenterol Hepatol 2021;19(6):1098–107. e1.

Lesmana CRA, Raharjo M, Gani RA. Managing liver cirrhotic complications: Overview of esophageal and gastric varices. Clin Mol Hepatol 2020;26(4):444–60.

Lee EW, Shahrouki P, Alanis L, Ding P, Kee ST. Management options for gastric variceal hemorrhage. JAMA Surg 2019;154(6):540–8.

Shen D, Qian X, Wang J, Li F, Fang Q, Zhao J, et al. Risk factor analysis of non-acute symptomatic portal vein thrombosis after endoscopic gastric variceal injection. J Chin Physician 2021;23(3):338–42.

Philips CA, Ahamed R, Rajesh S, George T, Mohanan M, Augustine P. Beyond the scope and the glue: update on evaluation and management of gastric varices. BMC Gastroenterol 2020;20(1):361.

Jakab SS, Garcia-Tsao G. Evaluation and management of esophageal and gastric varices in patients with cirrhosis. Clin Liver Dis 2020;24(3):335–50.

Ahmed A, Ali L, Shehbaz L, Nasir S, Rizvi SR, Aman MZ, et al. The prevalence of acute upper gastrointestinal bleeding and the factors causing hemorrhage as observed at a tertiary health care centre in Karachi, Pakistan. Pak J Surg 2017;33(1):36–40.

Shatzel JJ, O’Donnell M, Olson SR, Kearney MR, Daughety MM, Hum J, et al. Venous thrombosis in unusual sites: a practical review for the hematologist. Eur J Haematol 2019;102(1):53–62.

Vine LJ, Subhani M, Acevedo JG. Update on management of gastric varices. World J Hepatol 2019;11(3):250–60.

McCarty TR, Bazarbashi AN, Hathorn KE, Thompson CC, Ryou M. Combination therapy versus monotherapy for EUS-guided management of gastric varices: A systematic review and meta-analysis. Endosc Ultrasound 2020;9(1):6–15.

Goral V, Y?lmaz N. Current approaches to the treatment of gastric varices: glue, coil application, TIPS, and BRTO. Medicina (Kaunas) 2019;55(7):335.

Al-Bawardy B, Gorospe EC, Saleem A, Buttar NS, Wong Kee Song LM. Outcomes and predictors of rebleeding after 2-octyl cyanoacrylate injection in acute gastric variceal hemorrhage. J Clin Gastroenterol 2016;50(6):458–63.

Thiruvengadam SS, Sedarat A. The role of endoscopic ultrasound (EUS) in the management of gastric varices. Curr Gastroenterol Rep 2021;23(1):1.

Lee HA, Chang JM, Goh HG, Kim TH, Lee YS, Suh SJ, et al. Prognosis of patients with gastric variceal bleeding after endoscopic variceal obturation according to the type of varices. Eur J Gastroenterol Hepatol 2019;31(2):211–7.

Al-Khazraji A, Curry MP. The current knowledge about the therapeutic use of endoscopic sclerotherapy and endoscopic tissue adhesives in variceal bleeding. Expert Rev Gastroenterol Hepatol 2019;13(9):893–7.

Yang W, Yusufu Y, Wang C. Gastrointestinal: A rare case of upper gastrointestinal bleeding: Splenosis mimicking gastric varices. J Gastroenterol Hepatol 2022;37(9)1651.

Lizardo-Sanchez L, Burdick J, Trotter JF, editors. Safety and efficacy of 2-octyl-cyanoacrylate in the management of patients with gastric and duodenal varices who are not candidates for transjugular intrahepatic portosystemic shunts. Proc (Bayl Univ Med Cent) 2016;29(4):371–3.

Jun CH, Kim KR, Yoon JH, Koh HR, Choi WS, Cho KM, et al. Clinical outcomes of gastric variceal obliteration using N-butyl-2-cyanoacrylate in patients with acute gastric variceal hemorrhage. Korean J Intern Med 2014;29(4):437–44.

Mosli MH, Aljudaibi B, Almadi M, Marotta P. The safety and efficacy of gastric fundal variceal obliteration using N-butyl-2-cyanoacrylate; the experience of a single Canadian tertiary care centre. Saudi J Gastroenterol 2013;19(4):152–9.

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Published

30-09-2023

How to Cite

1.
Kabir M, N, Fareed S, Hameed K, Ali M, Arif M. SAFETY AND EFFICACY OF N-BUTYL-2-CYANOACRYLATE FOR MANAGEMENT OF GASTRIC VARICES. Pak J Phsyiol [Internet]. 2023 Sep. 30 [cited 2024 May 17];19(3):7-10. Available from: https://www.pjp.pps.org.pk/index.php/PJP/article/view/1502