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118 MANAGMENT OF BLEEDING GASTRIC VARICES WITH HISTOACRYL GLUE INJECTION - LONG-TERM OUTCOMES J Al Ali, M Byrne, J Cheung, S Whittaker, U Stienbreacher, R Enns Gastric variceal bleeding is an uncommon serious complication of portal hypertension. The management of this complication has not been standardized, however, transjugular intrahepatic portosystemic shunt (TIPS) is widely used in the many centres. Endoscopic treatment with histoacryl glue is another treatment option that can be performed acutely in any GI unit. We have performed this on a number of patients and hypothesized that many of these patients may be dying of other causes (as opposed to exsanguination). We reviewed our long-term outcomes to determine survival and benefit of histoacryl injection therapy of fundal varices.
Department of Medicine, Division of Gastroenterology, St Paul's and Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia
METHODS: Aretrospective chart review (2001 to 2005) inclusive of all patients treated with histoacryl glue injection for bleeding gastric fundal varices.
RESULTS: Eighteen patients were treated with histoacryl glue for bleeding gastric varices. Complete data is pending on three patients; therefore, analysis was performed on the remaining 15 patients (eight male). At a follow up median of more than 24 months, 11 (61.1%) were alive and functioning at high levels. There were no immediate complications of injection therapy. Repeat endoscopic examination was performed for assessment in six patients with repeat injection in three. There were no cases of delayed repeat hemorrhage. No patients died of hemorrhage.
CONCLUSION: Short-term treatment of bleeding fundal varices with glue has been demonstrated to be helpful, however, in this study, long-term outcomes of 'glue' injections in these patients have a favorable survival which strongly supports the use of this endoscopic modality of therapy. Further data is being collected on remaining patients which we feel is likely to support this therapy.