ENDOSCOPIC HISTOACRYL INJECTION IS SAFE AND EFFECTIVE MODAILTY FOR HEMOSTASIS OF BOTH ACUTE VARICEAL AND NON-VARICEAL BLEEDING

Aims:

Histoacryl is one of the materials that can be used as a sclerosing agent and is known to be effective in endoscopic hemostasis of acute gastric variceal bleeding. In addition, it can be applied to hemostasis of ulcer bleeding with relatively simple manipulation and is also effective. We reviewed patients who had undergone treatment endoscopically with Histoacryl and assessed the effectiveness and side effects according to each disease.

Methods:

We retrospectively reviewed 100 cases treated endoscopically with Histoacryl in Seoul Paik Hospital from January 2004 to October 2018. All cases were categorized by each disease. For the cases of bleeding, initial hemostasis rate and rebleeding rate within 7 days were evaluated. We reviewed the procedure records and post-procedure medical records to confirm the adverse effects.

Results:

Among 100 cases treated with Histoacryl, 92 cases were upper GI bleedings, 8 cases were fistula. Among upper GI bleeding cases, 79 were variceal bleedings, 12 were ulcer bleedings, and 1 was post-ESD bleedings. Gastric variceal bleeding accounted for the majority of variceal bleeding in 72 of 79 cases (91.1%). Among the ulcer bleeding, there were 9 cases of gastric ulcer and 3 cases of duodenal ulcer. Initial hemostasis was obtained from all bleeding cases. The delayed bleeding rate within 7 days was 9.9% of all bleeding cases, 10.0% of variceal hemorrhage cases, and 9.1% of ulcer bleeding cases. No significant complication was observed, but 3 patients were expired within six months for reasons unrelated to this procedure.

Conclusions:

According to our data, Histoacryl treatment is relatively safe and has a high success rate of hemostasis not only for variceal bleeding but also for ulcer bleeding. Therefore, it is considered to be a useful method for upper GI bleeding which is difficult to hemostasis.