SAFETY AND EFFICACY OF N-BUTYL-2-CYANOACRYLATE FOR MANAGEMENT OF GASTRIC VARICES

Abstract

Background: Gastric varices (GVs) bleed less frequently than oesophageal varices. Gastric variceal bleeding tends to be severe with higher mortality and re-bleed frequently after spontaneous haemostasis. This study evaluated the safety and efficacy of N-Butyl-2-Cyanoacrylate for the management of gastric varices in patients presenting to tertiary care setting. Methods: This descriptive case study was performed at Department of Gastroenterology and Hepatology, Hayatabad Medical Complex, Peshawar between Jan and July 2022. Seventy-three patients of either gender were included in the study. Screening and interventional endoscopy were done and patient were observed for efficacy and safety of N-Butyl-2-Cyanoacrylate injection. Data was analysed using SPSS-22. Results: The mean age and BMI of the patients were 54.96±2.64 years and 28.98±246 Kg/m² respectively. There were 75.78% male and 24.21% female (M:F=31:1) patients. The aetiological cause of gastric varices was Hepatitis-B virus in 62.10%, alcohol in 23.15% and other causes in 14.73% patients. Child Pugh Class was A in 37.89% patients, B in 50.52% and C in 11.57% patients. Adequate haemostasis was achieved in 95.78% patients and re-bleeding was observed in 30.52% patients. Fever was recorded in 5.26% patients, abdominal pain in 3.15% and diarrhoea in 1.05%. Spontaneous bacterial peritonitis was not reported in any case (0.0%). Conclusion: N-Butyl-2-Cyanoacrylate is efficacious and safe for the management of gastric varices.

Pak J Physiol 2023;19(3):7–10