Abstract
Background and study aims
The optimal treatment for gastric varices (GVs) is a topic that remains definite for this study. This study compared the clinical outcomes of clip-assisted endoscopic cyanoacrylate injection (clip-ECI) to conventional endoscopic cyanoacrylate injection (con-ECI) for the treatment of GVs with a gastrorenal shunt.
Patients and methods
Data were collected retrospectively in five medical centers from 2015 to 2020. The patients were treated with con-ECI (n = 126) or clip-ECI (n = 148). Clinical characteristics and procedural outcomes were compared. Patients were followed until death, liver transplantation or 6 months after the treatment. The primary outcome was rebleeding, and the secondary outcome was survival.
Results
There were no significant differences in age, sex, etiology, shunt diameter and Child-Pugh classification between the two groups. Fewer GVs obliteration sessions were required in the clip-ECI group than in the con-ECI group (p = 0.015). The cumulative 6-month rebleeding-free rates were 88.6% in the clip-ECI group and 73.7% in the con-ECI group (p = 0.002). The cumulative 6-month survival rates were 97.1% in the clip-ECI group and 94.8% in the con-ECI group (p = 0.378).
Conclusions
Compared with con-ECI, clip-ECI appears more effective for the treatment of GVs with a gastrorenal shunt, which required less sessions and achieved a higher 6-month rebleeding-free rate.
Acknowledgments
The authors thank Lianhui Zhao, Yifu Xia and Dongxin Hu for their assistance.
Author contributions
Study design: Chunqing Zhang, Mingyan Zhang; Data acquisition: Haijun Mou, Ruonan Sun, Jinming Yan, Qian Feng; Data analysis: Ruonan Sun, Guangjun Huang; Statistical analyses and consulting: Guangchuan Wang; Data interpretation: Haijun Mou, Mingyan Zhang, Yongjun Shi; Drafting of the manuscript: Mingyan Zhang; Revision for important intellectual content: Chunqing Zhang, Biguang Tuo, Derun Kong, Ping Li, Senlin Li.
Disclosure statement
No potential conflict of interest was reported by the author(s).