Korean J Gastrointest Endosc > Volume 23(2); 2001 > Article

Korean Journal of Gastrointestinal Endoscopy 2001;23(2): 69-75.

위정맥류 출혈에 대한 N-butyl 2-Cyanoacrylate 주사요법의 치료 효과 ( Efficacy of N-Butyl 2-Cyanoacrylate Injection Therapy for Gastric Variceal Bleeding )

김상우(Sang Woo Kim),정인식(In Sik Chung),송호진(Ho Jin Song),왕준호(Joon Ho Wang),이강문(Kang Moon Lee),이동수(Dong Soo Lee),윤종구(Jong Goo Yoon),김성수(Sung Soo Kim),양영상(Young Sang Yang),최명규(Myung Gyu Choi),김재광(Jae Kwang Kim),박두호(Doo Ho Park)

Abstract

Background/Aims:
The aim of the study was to evaluate the efficacy of n-butyl 2-cyanoacrylate injection therapy for gastric variceal bleeding and to find out the factors related to clinical outcome,
Methods:
Sixty-seven patients treated with n-butyl 2-cyanoacrylate injection therapy for gastric variceal bleeding were retrospectively reviewed.
Results:
Initial hemostasis was achieved in all 12 patients, Success of therapy was achieved in 88% of the patients. A stepwise logistic regression analysis including age, sex, cause of cirrhosis, Child-Pugh class, variceal form, bleeding site, initial hemoglobin, and presence of hepatocellular carcinoma as variables indicated that only the Child-Pugh class was an independent predictive factor of treatment failure. Rebleeding occurred in 19% of the patients during the 4 weeks after therapy, The cumulative probability of 4-week remaining free of rebleeding was significantly higher in Child-Pugh A and B than in Child- Pugh C. Mortality at 4 weeks was 15%. The Child-Pugh class and the presence of hepatocellular carcinoma were the independent predictive factors of mortality at 4 weeks,
Conclusions:
N-butyl 2-cyanoacrylate injection therapy is highly effective in the management of bleeding from gastric varices, Child-Pugh class is an important predictive factor of treatment failure, rebleeding, and survival after the therapy. (Korean J Gastrointest Endosc 2001;23:69-75)

Key Words: 위정맥류 , 출혈 , N-butyl 2-cyanoacrylate , Gastric varix , Bleeding