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
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
First
Prev
