Undiluted cyanoacrylate glue for gastric variceal haemorrage : retrospective study from a single tertiary care centre in South India (CMC Vellore)

Parika Kalra, Rupesh Kalyan, Viswanath R .

Abstract


Background : Gastric variceal bleed is a life threatening  and endoscopic glue (n-butyl-2-cyanoacrylate) is the recommended treatment. Serious embolic            complications are associated with lipoidal diluted glue. In this study, we aim to analyse the safety of undiluted glue for gastric variceal haemorrhage. Methods : Patients who underwent undiluted glue injection for gastric varices from 2006 to 2016 at Christian Medical College, Vellore were  included in this retrospective cohort study. Result : One hundred and ninety five patients (male: 68; age: 44, 5-75; median, range) underwent endoscopic glue injection out of which 46 underwent repeat injection sessions. Cryptogenic cirrhosis (26.6%) followed by ethanol (20%) were the                commonest cause of portal hypertension. Total 252 glue injection sessions were performed (117 - acute gastric variceal bleed, 135 – secondary prophylaxis) and median volume of glue injected was 1ml (0.5-3; range) and 2% mortality noted (3-failed glue, 1-pulmonary embolism).       Conclusion: Undiluted n-butyl-2-cyanoacrylate glue is safe for control of gastric variceal haemorrhage.


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