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Procedure-related complications in gastric variceal obturation with tissue glue
AIM: To focus on procedure-related complications, evaluate their incidence, analyze the reasons and discuss the solutions. METHODS: Overall, 628 endoscopic gastric variceal obturation (EGVO) procedures (case-times) with NBC were performed in 519 patients in the Department of Endoscopy of the Third A...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5703934/ https://www.ncbi.nlm.nih.gov/pubmed/29209115 http://dx.doi.org/10.3748/wjg.v23.i43.7746 |
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author | Guo, Yun-Wei Miao, Hui-Biao Wen, Zhuo-Fu Xuan, Jie-Ying Zhou, Hao-Xiong |
author_facet | Guo, Yun-Wei Miao, Hui-Biao Wen, Zhuo-Fu Xuan, Jie-Ying Zhou, Hao-Xiong |
author_sort | Guo, Yun-Wei |
collection | PubMed |
description | AIM: To focus on procedure-related complications, evaluate their incidence, analyze the reasons and discuss the solutions. METHODS: Overall, 628 endoscopic gastric variceal obturation (EGVO) procedures (case-times) with NBC were performed in 519 patients in the Department of Endoscopy of the Third Affiliated Hospital of Sun Yat-Sen University from January 2011 to December 2016. The clinical data of patients and procedure-related complications of EGVO were retrospectively analyzed. RESULTS: In the 628 EGVO procedures, sticking of the needle to the varix occurred in 9 cases (1.43%), including 1 case that used lipiodol-diluted NBC and 8 cases that used undiluted NBC (P = 0.000). The needle was successfully withdrawn in 8 cases. Large spurt bleeding occurred in one case, and hemostasis was achieved by two other injections of undiluted glue. The injection catheter became blocked in 17 cases (2.71%) just during the injection, and 4 cases were complicated with the needle sticking to the varix. Large glue adhesion to the endoscope resulted in difficulty withdrawing the endoscope in 1 case. Bleeding from multiple sites was observed in the esophagus and gastric cardia after the endoscope was withdrawn. Hemostasis was achieved by 1% aethoxysklerol injection and intravenous somatostatin. The ligation device stuck to the varices in two cases during the subsequent endoscopic variceal ligation. In one case, the ligation device was successfully separated from the esophageal varix after all bands were released. In another case, a laceration of the vein and massive bleeding were observed. The bleeding ceased after 1% aethoxysklerol injection. CONCLUSION: Although EGVO with tissue glue is usually safe and effective, a series of complications can occur during the procedure that may puzzle endoscopists. There is no standard operating procedure for addressing these complications. The cases described in the current study can provide some reference for others. |
format | Online Article Text |
id | pubmed-5703934 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-57039342017-12-05 Procedure-related complications in gastric variceal obturation with tissue glue Guo, Yun-Wei Miao, Hui-Biao Wen, Zhuo-Fu Xuan, Jie-Ying Zhou, Hao-Xiong World J Gastroenterol Retrospective Study AIM: To focus on procedure-related complications, evaluate their incidence, analyze the reasons and discuss the solutions. METHODS: Overall, 628 endoscopic gastric variceal obturation (EGVO) procedures (case-times) with NBC were performed in 519 patients in the Department of Endoscopy of the Third Affiliated Hospital of Sun Yat-Sen University from January 2011 to December 2016. The clinical data of patients and procedure-related complications of EGVO were retrospectively analyzed. RESULTS: In the 628 EGVO procedures, sticking of the needle to the varix occurred in 9 cases (1.43%), including 1 case that used lipiodol-diluted NBC and 8 cases that used undiluted NBC (P = 0.000). The needle was successfully withdrawn in 8 cases. Large spurt bleeding occurred in one case, and hemostasis was achieved by two other injections of undiluted glue. The injection catheter became blocked in 17 cases (2.71%) just during the injection, and 4 cases were complicated with the needle sticking to the varix. Large glue adhesion to the endoscope resulted in difficulty withdrawing the endoscope in 1 case. Bleeding from multiple sites was observed in the esophagus and gastric cardia after the endoscope was withdrawn. Hemostasis was achieved by 1% aethoxysklerol injection and intravenous somatostatin. The ligation device stuck to the varices in two cases during the subsequent endoscopic variceal ligation. In one case, the ligation device was successfully separated from the esophageal varix after all bands were released. In another case, a laceration of the vein and massive bleeding were observed. The bleeding ceased after 1% aethoxysklerol injection. CONCLUSION: Although EGVO with tissue glue is usually safe and effective, a series of complications can occur during the procedure that may puzzle endoscopists. There is no standard operating procedure for addressing these complications. The cases described in the current study can provide some reference for others. Baishideng Publishing Group Inc 2017-11-21 2017-11-21 /pmc/articles/PMC5703934/ /pubmed/29209115 http://dx.doi.org/10.3748/wjg.v23.i43.7746 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Retrospective Study Guo, Yun-Wei Miao, Hui-Biao Wen, Zhuo-Fu Xuan, Jie-Ying Zhou, Hao-Xiong Procedure-related complications in gastric variceal obturation with tissue glue |
title | Procedure-related complications in gastric variceal obturation with tissue glue |
title_full | Procedure-related complications in gastric variceal obturation with tissue glue |
title_fullStr | Procedure-related complications in gastric variceal obturation with tissue glue |
title_full_unstemmed | Procedure-related complications in gastric variceal obturation with tissue glue |
title_short | Procedure-related complications in gastric variceal obturation with tissue glue |
title_sort | procedure-related complications in gastric variceal obturation with tissue glue |
topic | Retrospective Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5703934/ https://www.ncbi.nlm.nih.gov/pubmed/29209115 http://dx.doi.org/10.3748/wjg.v23.i43.7746 |
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