Korean Journal of Gastrointestinal Endoscopy 2005;31(2): 84-89.
위 정맥류 출혈에서 비중차를 이용한 HistoacrylTM (enbucrilate)- LipiodolTM (ethiodized oil) 연속 주입법의 성적
김태오ㆍ허정ㆍ이성훈ㆍ권대식ㆍ김광하ㆍ강대환ㆍ송근암ㆍ조몽
부산대학교 의과대학 내과학교실
Results of Histoacryl-Lipiodol Sequential Injection Using Specific Gradient Difference for Bleeding Gastric Varices
Tae Oh Kim, M.D., Jeong Heo, M.D., Seong Hun Lee, M.D., Dae Sik Gwon, M.D.,Gwang Ha Kim, M.D., Dae Hwan Kang, M.D., Geun Am Song, M.D. and Mong Cho, M.D.
Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea
Abstract
Background/Aims: Histoacryl forms hard substances in an instance after a brief exposure to polar liquid, blood or body temperature. This often causes obstruction of injector and endoscopic channel. Furthermore, splashed Histoacryl during injection can lead to accidental loss of vision. We propose a new convenient method of Histoacryl-lipiodol sequential injection and report the results. Methods: From May 2001 to August 2004, sequential injector method was performed in treating consecutive thirty gastric varices patients. Histoacryl (S.G. 1.0) 1 mL and lipiodol (S.G. 1.28) 1∼1.5 mL are filled in 2.5 mL disposable syringe with 16 gauge needle, which are separated into two compartments by specific gravity difference. The injector attached side of charged syringe is gently placed upward and the piston is pushed after the lesion site puncture. Then, normal saline is promptly infused to wash out and the needle is withdrawn. Results: There were 26 males and 4 females. 4 had active bleeding and 26 had the stigmata of bleeding. Varices types were Lg-c in 10, Lg-cf in 16 and Lg-f in 4 patients and the Child-Pugh classification were A in 17%, B in 53% and C in 30%. The average amount was 1.53 mL. Initial hemostasis rate was 97%, 3 of patients re-bled in 4 weeks and 2 patients later. One patient died after the procedure and a case of procedure related bacteremia has occurred. Conclusions: Histoacryl-lipiodol sequential injection by specific gravity difference is convenient and safe. Also, it carries less damage to the instruments. (Korean J Gastrointest Endosc 2005;31:8489)
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