Endoscopic obliterative therapy with n-butyl-2- cyanoacrylate for gastrointestinal varices

Aims: To evaluate the utility of endoscopic obliterative therapy with n-butyl-2-cyanoacrylate (tissue adhesives) for gastrointestinal varices and to investigate the incidence of serious complications. Methods: Endoscopic obliterative therapy with n-butyl-2-cyanoacrylate was performed on 228 gastrointestinal variceal patients; 221 gastric varices, 5 duodenal varices, and 2 anastomotic varices after choledochojejunostomy. Endoscopic therapy was performed under fluoroscopy using 70% or 83% cyanoacrylate diluted with 5% Lipiodol. Results: Endoscopic obliterative therapy with cyanoacrylate for gastrointestinal varices was successful in all 228 cases. The incidence of serious complications was 4/228 (1.8%), including two cases of splenic infarction, one of pulmonary embolism, and one of an inflammatory tumor of the pancreatic tail, and all these 4 cases for gastric varices. Conclusions: Endoscopic obliterative therapy with cyanoacrylate is a useful and relatively safe method for treatment of bleeding gastrointestinal varices. Nonetheless, careful attention must be paid to avoid potentially serious complications. Correspondence to: Dr. Takahiro Sato, Department of Gastroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo 0600033, Japan; Tel: + 8 1 1 1 2 6 1 5 3 3 1 ; F a x : + 8 1 1 1 2 6 1 6 0 4 0 ; E m a i l : [email protected]