Clinical and Molecular Hepatology

"Sang Jun Suh"

Original Articles

Liver fibrosis, cirrhosis, and portal hypertension

Cyanoacrylate injection versus band ligation for bleeding from cardiac varices along the lesser curvature of the stomach: Sang Jung Park, Yong Kwon Kim, Yeon Seok Seo, Seung Woon Park, Han Ah Lee, Tae Hyung Kim, Sang Jun Suh, Young Kul Jung, Ji Hoon Kim, Hyunggin An, Hyung Joon Yim, Jae Young Jang, Jong Eun Yeon, Kwan Soo Byun; Clin Mol Hepatol 2016;22(4):487-494.
Published online December 25, 2016; DOI: https://doi.org/10.3350/cmh.2016.0050

Abstract
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Background/Aims
Practice guidelines recommend endoscopic band ligation (EBL) and endoscopic variceal obturation (EVO) for bleeding from esophageal varices and fundal varices, respectively. However, the optimal treatment for bleeding from cardiac varices along the lesser curvature of the stomach (GOV1) remains undefined. This retrospective study compared the efficacy between EBL and EVO for bleeding from GOV1.
Methods
Patients treated by EBL or EVO via cyanoacrylate injection for bleeding from GOV1 were enrolled. Patients diagnosed with hepatocellular carcinoma or treated with endoscopic injection sclerotherapy were excluded.
Results
The study included 91 patients treated for bleeding from GOV1. The mean age was 56.3±10.9 years (mean±SD), and 78 of them (85.7%) were men. Overall, 51 and 40 patients were treated with EBL and EVO, respectively. A trend for a higher hemostasis rate was noted in the EVO group (100%) than in the EBL group (82.6%, P=0.078). Varices rebled in 15 patients during follow-up. The rebleeding rate was significantly higher in the EBL group than in the EVO group (P=0.004). During follow-up, 13 patients died (11 in the EBL group and 2 in the EVO group); the survival rate was marginally significant between two groups (P=0.050). The rebleeding-free survival rate was significantly higher in the EVO group than in the EBL group (P=0.001).
Conclusions
Compared to EBL, EVO offered significantly lower rebleeding rates, significantly higher rebleeding-free survival rates, and a trend for higher hemostasis and survival rates. EVO appears to be the better therapeutic option for bleeding from GOV1.

Citations

Citations to this article as recorded by

Endoscopic management of acute esophagogastric variceal bleeding: recent advances
Xinhui Li, Jing Wang, Qun Li, Wenbo Li, Xingshun Qi, Xiaofeng Liu
Therapeutic Advances in Gastroenterology.2026;[Epub] CrossRef
Portal hypertension in the era of endo-hepatology: Emerging diagnostic and therapeutic roles of endoscopy and endoscopic ultrasound
Savita Madhankumar, Dareen S Chuy, Isabella Hillman, Saikalyan Thimirisetty, Anokhi Amara, Micheal Tadros
World Journal of Gastrointestinal Endoscopy.2026;[Epub] CrossRef
Endoscopic variceal ligation versus cyanoacrylate injection for acute variceal bleeding from the cardia to the lesser curvature
Yu-Fu Chen, Tsung-Chieh Yang, Ping-Han Hsieh, Yu-Jen Chen, Hsiao-Sheng Lu, Kuei-Chuan Lee, Hui-Chun Huang, Jiing-Chyuan Luo, Ming-Chih Hou
Journal of the Chinese Medical Association.2026; 89(7): 497. CrossRef
Short-term efficacy and safety of endoscopic injection of low dose of sclerotherapy and cyanoacrylate injection for type GOV1 gastric varices combined with endoscopic variceal ligation for esophageal varices
Tingting Zhang, Chuangyang Xin, Xueyun Guo, Sihai Chen, Xuelian Zheng, Wen Xu, Dongjing Zhang, Biming Li, Ye Chen, Xuan Zhu, Anjiang Wang
Surgical Endoscopy.2025; 39(1): 280. CrossRef
Emergency Plug-Assisted Retrograde Transvenous Obliteration for Active Bleeding from Ruptured Gastric Varices
Eunbyeol Ko, Jeongyeon Kim, Dong Il Gwon, Hee Ho Chu, Gun Ha Kim, Gi-Young Ko
Journal of Vascular and Interventional Radiology.2025; 36(6): 994. CrossRef
A randomized controlled trial comparing large-volume band ligator and cyanoacrylate injection in the endoscopic management of actively bleeding gastric varices
Ding Shi, Guojing Xu, Weijin Pan
Scientific Reports.2025;[Epub] CrossRef
Evaluation of the efficacy and safety of endoscopic band ligation in the treatment of bleeding from mild to moderate gastric varices type 1
Yue Deng, Ya Jiang, Tong Jiang, Ling Chen, Hai-Jun Mou, Bi-Guang Tuo, Guo-Qing Shi
World Journal of Gastroenterology.2024; 30(5): 440. CrossRef
Gastric variceal obstruction improves the efficacy of endoscopic management of esophageal variceal bleeding in GOV type I
Xiaoquan Huang, Detong Zou, Huishan Wang, Wei Chen, Lili Zhang, Feng Li, Lili Ma, Chunqing Zhang, Ying Chen, Shiyao Chen
Endoscopy International Open.2024; 12(08): E940. CrossRef
Aluminum phosphate gel reduces early rebleeding in cirrhotic patients with gastric variceal bleeding treated with histoacryl injection therapy
Hao-Tian Zeng, Zhu-Liang Zhang, Xi-Min Lin, Min-Si Peng, Li-Sheng Wang, Zheng-Lei Xu
World Journal of Gastrointestinal Endoscopy.2023; 15(3): 153. CrossRef
A case report of an endoscopic approach to life‐threatening cecal variceal hemorrhage
Kirsty E MacFarlane, Nicholas J Fischer
JGH Open.2022; 6(4): 277. CrossRef
Endoscopic variceal obturation and retrograde transvenous obliteration for acute gastric cardiofundal variceal bleeding in liver cirrhosis
Han Ah Lee, Jungwon Kwak, Sung Bum Cho, Young-Sun Lee, Young Kul Jung, Ji Hoon Kim, Seung Up Kim, Hyonggin An, Hyung Joon Yim, Jong Eun Yeon, Yeon Seok Seo
BMC Gastroenterology.2022;[Epub] CrossRef
Diagnosis and Management of Esophageal and Gastric Variceal Bleeding: Focused on 2019 KASL Clinical Practice Guidelines for Liver Cirrhosis
Min Kyung Park, Yun Bin Lee
The Korean Journal of Gastroenterology.2021; 78(3): 152. CrossRef
Endoscopic Removal of Inflated Transected Sengstaken–Blakemore Tube Using Endoscopic Scissors
Jun Ho Lee, Eu-Kwon Hwang, Chanmesa Doeun, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
Clinical Endoscopy.2019; 52(2): 182. CrossRef
Prevention and management of gastroesophageal varices
Yeon Seok Seo
Clinical and Molecular Hepatology.2018; 24(1): 20. CrossRef
The Choice of Interventional Treatment of Gastric Variceal Hemorrhage: What Is Better?
Moon Young Kim
Gut and Liver.2018; 12(6): 611. CrossRef
Endoscopic Therapy for Variceal Bleeding: from Patient Preparation to Available Techniques and Rescue Therapies
Philippe Sultanik, Dominique Thabut
Current Hepatology Reports.2017; 16(4): 398. CrossRef

13,710 View
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17 Web of Science
Crossref

Viral hepatitis

Hepatitis B surface antigen titer is a good indicator of durable viral response after entecavir off-treatment for chronic hepatitis B: Han Ah Lee, Yeon Seok Seo, Seung Woon Park, Sang Jung Park, Tae Hyung Kim, Sang Jun Suh, Young Kul Jung, Ji Hoon Kim, Hyunggin An, Hyung Joon Yim, Jong Eun Yeon, Kwan Soo Byun, Soon Ho Um; Clin Mol Hepatol 2016;22(3):382-389.
Published online September 25, 2016; DOI: https://doi.org/10.3350/cmh.2016.0047

Abstract
PDF

Background/Aims
Clear indicators for stopping antiviral therapy in chronic hepatitis B (CHB) patients are not yet available. Since the level of hepatitis B surface antigen (HBsAg) is correlated with covalently closed circular DNA, the HBsAg titer might be a good indicator of the off-treatment response. This study aimed to determine the relationship between the HBsAg titer and the entecavir (ETV) off-treatment response.
Methods
This study analyzed 44 consecutive CHB patients (age, 44.6±11.4 years, mean±SD; men, 63.6%; positive hepatitis B envelope antigen (HBeAg) at baseline, 56.8%; HBV DNA level, 6.8±1.3 log10 IU/mL) treated with ETV for a sufficient duration and in whom treatment was discontinued after HBsAg levels were measured. A virological relapse was defined as an increase in serum HBV DNA level of >2000 IU/mL, and a clinical relapse was defined as a virological relapse with a biochemical flare, defined as an increase in the serum alanine aminotransferase level of >2 × upper limit of normal.
Results
After stopping ETV, virological relapse and clinical relapse were observed in 32 and 24 patients, respectively, during 20.8±19.9 months of follow-up. The cumulative incidence rates of virological relapse were 36.2% and 66.2%, respectively, at 6 and 12 months, and those of clinical relapse were 14.3% and 42.3%. The off-treatment HBsAg level was an independent factor associated with clinical relapse (hazard ratio, 2.251; 95% confidence interval, 1.076–4.706; P=0.031). When patients were grouped according to off-treatment HBsAg levels, clinical relapse did not occur in patients with an off-treatment HBsAg level of ≤2 log₁₀ IU/mL (n=5), while the incidence rates of clinical relapse at 12 months after off-treatment were 28.4% and 55.7% in patients with off-treatment HBsAg levels of >2 and ≤3 log₁₀ IU/mL (n=11) and >3 log₁₀ IU/mL (n=28), respectively.
Conclusions
The off-treatment HBsAg level is closely related to clinical relapse after treatment cessation. A serum HBsAg level of <2 log₁₀ IU/mL is an excellent predictor of a sustained off-treatment response in CHB patients who have received ETV for a sufficient duration.

Citations

Citations to this article as recorded by

Efficacy and Safety of Switching from Entecavir to Tenofovir Alafenamide in Chronic Hepatitis B: A Multicenter Randomized Trial in Korea
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Gut and Liver.2026; 20(4): 636. CrossRef
KASL clinical practice guidelines for management of chronic hepatitis B Endorsed by the East Asia Liver Alliance (EALA)
Won-Mook Choi, Ji Won Han, Tae Hyung Kim, Miyoung Choi, Moon Haeng Hur, Hyo Young Lee, Han Ah Lee, Byeong Geun Song, Heechul Nam, Jeong-Ju Yoo, Chang Hun Lee, Gi-Ae Kim, Hye Won Lee, Gwang Hyeon Choi, Young Eun Chon, Yun Bin Lee, Dong Hyun Sinn, Bo Hyun K
Clinical and Molecular Hepatology.2026; 32(3): 1029. CrossRef
Translational Strategies to Eliminate Chronic Hepatitis B in Children: Prophylaxis and Management in East Asian Countries
Ben Kang, Dae Yong Yi, Byung-Ho Choe
Frontiers in Pediatrics.2022;[Epub] CrossRef
KASL clinical practice guidelines for management of chronic hepatitis B

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Takehisa Watanabe, Sanae Hayashi, Yasuhito Tanaka
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Arthrospira Enhances Seroclearance in Patients with Chronic Hepatitis B Receiving Nucleos(t)ide Analogue through Modulation of TNF-α/IFN-γ Profile
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Nutrients.2022; 14(14): 2790. CrossRef
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Niraj James Shah, Mark M Aloysius, Neil Rohit Sharma, Kumar Pallav
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Samuel Anthony Lachlan Hall, Sara Vogrin, Olivia Wawryk, Gareth S Burns, Kumar Visvanathan, Vijaya Sundararajan, Alexander Thompson
Gut.2021; : gutjnl-2020-323979. CrossRef
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Niraj James Shah, Mark M Aloysius, Neil Rohit Sharma, Kumar Pallav
World Journal of Gastrointestinal Pharmacology and Therapeutics.2021; 12(4): 56. CrossRef
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Florian van Bömmel, Thomas Berg
Hepatology Communications.2021; 5(10): 1632. CrossRef
Improving the Prediction of Relapse After Nucleos(t)ide Analogue Discontinuation in Patients With Chronic Hepatitis B
Do Seon Song, Jeong Won Jang, Sun Hong Yoo, Jung Hyun Kwon, Soon Woo Nam, Si Hyun Bae, Jong Young Choi, Seung Kew Yoon
Clinical Infectious Diseases.2021; 73(4): e892. CrossRef
Emerging Diagnostic Tools to Decide When to Discontinue Nucleos(t)ide Analogues in Chronic Hepatitis B
Margarita Papatheodoridi, George Papatheodoridis
Cells.2020; 9(2): 493. CrossRef
The Yin and the Yang of Treatment for Chronic Hepatitis B—When to Start, When to Stop Nucleos(t)ide Analogue Therapy
Samuel Hall, Jessica Howell, Kumar Visvanathan, Alexander Thompson
Viruses.2020; 12(9): 934. CrossRef
Comparison of clinical practice guidelines for the management of chronic hepatitis B: When to start, when to change, and when to stop
Hyung Joon Yim, Ji Hoon Kim, Jun Yong Park, Eileen L. Yoon, Hana Park, Jung Hyun Kwon, Dong Hyun Sinn, Sae Hwan Lee, Jeong-Hoon Lee, Hyun Woong Lee
Clinical and Molecular Hepatology.2020; 26(4): 411. CrossRef
Efficacy of 104-week Telbivudine-based optimization strategy in patients with HBeAg-negative chronic hepatitis B virus infections
Weiqiang Gan, Jianguo Li, Chunlan Zhang, Xuefu Chen, Chaoshuang Lin, Zhiliang Gao
BMC Infectious Diseases.2020;[Epub] CrossRef
Immunological biomarkers as indicators for outcome after discontinuation of nucleos(t)ide analogue therapy in patients with HBeAg‐negative chronic hepatitis B
Hariklia Kranidioti, Spilios Manolakopoulos, George Kontos, Michael S. Breen, Anastasia Kourikou, Melanie Deutsch, Maria Ester Quesada‐Del‐Bosque, Rocio T. Martinez‐Nunez, Mohammed M. Naiyer, Christopher H. Woelk, Tilman Sanchez‐Elsner, Emilia Hadziyannis
Journal of Viral Hepatitis.2019; 26(6): 697. CrossRef
KASL clinical practice guidelines for management of chronic hepatitis B

Clinical and Molecular Hepatology.2019; 25(2): 93. CrossRef
New Biomarkers of Chronic Hepatitis B
Lung-Yi Mak, Wai-Kay Seto, James Fung, Man-Fung Yuen
Gut and Liver.2019; 13(6): 589. CrossRef
Stopping long‐term treatment with nucleos(t)ide analogues is a favourable option for selected patients with HBeAg‐negative chronic hepatitis B
Florian van Bömmel, Thomas Berg
Liver International.2018; 38(S1): 90. CrossRef
An expert consensus for the management of chronic hepatitis B in Asian Americans
M. J. Tong, C. Q. Pan, S.‐H. B. Han, D. S.‐K. Lu, S. Raman, K.‐Q. Hu, J. K. Lim, H. W. Hann, A. D. Min
Alimentary Pharmacology & Therapeutics.2018; 47(8): 1181. CrossRef

16,144 View
210 Download
20 Web of Science
Crossref

Case Report

Hepatic neoplasm

A case of necrotizing pancreatitis subsequent to transcatheter arterial chemoembolization in a patient with hepatocellular carcinoma: Song-I Bae, Jong Eun Yeon, Jong Mee Lee, Ji Hoon Kim, Hyun Jung Lee, Sun Jae Lee, Sang Jun Suh, Eileen L. Yoon, Hae Rim Kim, Kwan Soo Byun, Tae-Seok Seo; Korean J Hepatol 2012;18(3):321-325.
Published online September 25, 2012; DOI: https://doi.org/10.3350/cmh.2012.18.3.321

Abstract
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Necrotizing pancreatitis is one of the rare complications of transcatheter arterial chemoembolization (TACE). Necrotizing pancreatitis after TACE may result from the development of ischemia caused by regurgitation of embolic materials into the vessels supplying the pancreas. We report a case of post-TACE necrotizing pancreatitis with abscess formation in a patient with hepatocellular carcinoma. The patient had suffered hepatic artery injury due to repetitive TACE; during his 25th TACE procedure he had submitted to selective catheterization of the feeding vessel from the dorsal pancreatic artery with a cytotoxic agent and Gelfoam particles. The patient complained of abdominal pain after the TACE procedure, and a CT scan led to a diagnosis of necrotizing pancreatitis with abscess formation. The pancreatic abscess progressed despite general management of the pancreatitis, including antibiotics. Percutaneous catheter drainage was performed, and the symptoms of the patient improved.

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