Official publication of Rawalpindi Medical University
Safety and Cost-Effectiveness of N-butyl-2-Cyanoacrylate without Lipiodol in Endoscopic Management of Gastric Varices
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Mahmood Ahmad, Fawad Iqbal, Muhammad Ayub, Nooman Gilani MAFIMANG. Safety and Cost-Effectiveness of N-butyl-2-Cyanoacrylate without Lipiodol in Endoscopic Management of Gastric Varices. JRMC [Internet]. 2020 Dec. 30 [cited 2024 Jun. 25];24(4). Available from: https://journalrmc.com/index.php/JRMC/article/view/1049

Abstract

Introduction: Gastric varices are frequently seen in patients with portal hypertension. The mainstay of treatment is variceal injection with a mixture of N-butyl-2-Cyanoacrylate and lipiodol. The use of N-butyl-2-Cyanoacrylate without lipiodol is not extensively studied and it can be a cost-effective approach. The objective of our study was to evaluate whether the use of N-butyl-2-Cyanoacrylate without lipiodol is a safe and effective endoscopic treatment for gastric varices.
Material and Methods: This prospective observational study was conducted between June 2016 and May 2017 at the Department of Gastroenterology, Gujranwala Medical College/ DHQ Teaching Hospital, Gujranwala. A total of 100 patients with gastric varices diagnosed on upper GI endoscopy were enrolled in the study. N-butyl-2-Cyanoacrylate without lipiodol was injected into the gastric varices of all the patients. All procedures were performed by experienced gastroenterologists. The patients underwent monthly follow-up endoscopies to determine the outcome and adverse events.
Results: Out of 100 patients, 40 patients (40 %) were men and 60 (60%) were women. The mean age was 53 years. The mean volume of N-butyl-2-Cyanoacrylate used per session was 1.5ml ± 0.5 ml (range 1-2ml). Obliteration of Gastric varices was achieved in 92 patients (92%) while in 04 patients (4%) varices did not obliterate over a mean follow-up of 12 months. No treatment-related immediate or late complications were observed in all patients. Four patients (4%) died of delayed rebleeding (after two weeks of intervention).
Conclusion: Injection therapy of gastric varices with N-butyl-2-Cyanoacrylate alone without lipiodol is a safe and cost-effective method for gastric varices.

https://doi.org/10.37939/jrmc.v24i4.1049
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Copyright (c) 2020 Mahmood Ahmad, Muhammad Ayub, Fawad Iqbal Janjua, Aisha Majeed, Nooman Gilani