Abstract
We evaluated the efficacy of endoscopic injection sclerotherapy (EIS) using cyanoacrylate in 17 cases with gastric varices, including the cases treated with high concentration of cyanoacrylate (67 or 75% Histoacryl (HA)). In all 8 cases with hemorrhagic gastric varices, we succeeded in hemostasis with this procedure. And the dose of cyanoacrylate needed was 2.0-4.0 ml in one session of EIS. The series of additional sclerotherapy using cyanoacrylate, ethanol, or ethanolamine oleate was performed to reduce the size of gastric varices in 11 cases. The results were complete disappearance of varices in 4 cases, marked reduction in 9 cases, and no change in 4 cases. Especially of 7 cases using the highest concentration of cyanoacrylate (75%HA), no additional sclerotherapy was needed in 5 cases, and 3 cases reached complete disappearance with one injection of 75%HA. In this procedure, the dose of cyanoacrylate needed was 2.5-8.0 ml in one session of EIS. In 4 cases inflow of cyanoacrylate polymer into subclavian vein or portal vein was noted. But no serious complication occurred. In conclusion, our procedure is considered to be a useful, convenient and safe in the therapy of gastric varices.
