内镜下注射氰基丙烯酸酯胶治疗十二指肠静脉曲张的单中心研究

IF 0.4 Q4 GASTROENTEROLOGY & HEPATOLOGY
S. Shafiq, H. Devarbhavi, Mallikarjun Patil
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引用次数: 0

摘要

摘要目的 十二指肠静脉曲张(DVs)虽然罕见,但可表现为大量、潜在致命的上消化道出血;然而,目前还没有关于这种相对罕见的表现的随机试验。我们的目的是报告我们的经验内镜下氰基丙烯酸酯胶注射DVs.材料和方法 我们回顾性评估了2010年1月至2021年12月期间我中心所有门静脉高压患者的医疗记录。收集并分析了氰基丙烯酸酯胶注射治疗DVs出血的人口学特征、病因、部位和有效性。结果在研究期间,共有5892例门静脉高压患者接受了内窥镜检查,其中41例(M:F = 29:12)平均年龄38岁的患者有DVs。肝外门静脉阻塞是最常见的病因(n = 26),DVs最常见的部位是十二指肠球部(n = 21)。在这41名患者中,21名(51%)患者主要表现为DV出血,并接受了内镜下氰基丙烯酸酯胶注射,成功止血,达到了指标出血;然而,在这21名患者中,有4名患者在随访2周至12个月期间再次出血,需要重复内治疗。。虽然有三名患者成功地重复注射了胶水,但有一名患者出现复发性大出血,无法接受腔内治疗,并接受了十二指肠切除术和分流手术。结论 虽然门静脉高压患者的DVs患病率为0.7%(41/5892),但DVs占门静脉高压相关出血的0.42%(21/4889)。在资源有限的情况下,氰基丙烯酸酯胶内皮治疗急性DV出血似乎是一种安全且具有成本效益的治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Endoscopic Cyanoacrylate Glue Injection for Duodenal Varices—A Single-Center Study
Abstract Aim/Objectives  Duodenal varices (DVs), although rare, can present with massive, potentially fatal upper gastrointestinal bleeding; however, there are no randomized trials regarding management of this relatively uncommon presentation. We aim to report our experience with endoscopic cyanoacrylate glue injection in patients with DVs. Materials and Methods  We retrospectively evaluated the medical records of all patients with portal hypertension at our center between January 2010 and December 2021. Demographic characteristics along with the etiology, location, and effectiveness of cyanoacrylate glue injection for bleeding DVs were collected and analyzed. Results A total of 5,892 patients with portal hypertension underwent endoscopy during the study period, of whom 41 patients (M:F = 29:12) with mean age of 38 years were noted to have DVs. While extrahepatic portal vein obstruction was the commonest etiology ( n  = 26), the most common site of DVs was the duodenal bulb ( n  = 21). Twenty-one (51%) out of these 41 patients presented primarily with DV bleeding and underwent endoscopic cyanoacrylate glue injection with successful hemostasis achieved of the index bleed; however, four of these 21 patients had rebleeding between 2 weeks and 12 months of follow-up requiring repeat endotherapy.. While three patients underwent successful repeat glue injections, one patient had recurrent massive bleedings, not amenable to endotherapy and was subjected to duodenal resection with surgical shunt procedure. Conclusion  While the prevalence of DVs in portal hypertension patients was 0.7% (41/5892), DVs accounted for 0.42% (21/4889) of portal hypertension-related bleedings. Endotherapy with cyanoacrylate glue appears to be a safe and cost-effective treatment for acute DV bleeding in a resource-limited setting.
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来源期刊
Journal of Digestive Endoscopy
Journal of Digestive Endoscopy GASTROENTEROLOGY & HEPATOLOGY-
自引率
28.60%
发文量
35
审稿时长
22 weeks
期刊介绍: The Journal of Digestive Endoscopy (JDE) is the official publication of the Society of Gastrointestinal Endoscopy of India that has over 1500 members. The society comprises of several key clinicians in this field from different parts of the country and has key international speakers in its advisory board. JDE is a double-blinded peer-reviewed, print and online journal publishing quarterly. It focuses on original investigations, reviews, case reports and clinical images as well as key investigations including but not limited to cholangiopancreatography, fluoroscopy, capsule endoscopy etc.
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