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EUS guided cyanoacrylate injection to prevent rebleeding in hepatocellular carcinoma patients with variceal hemorrhage

Journal of Gastroenterology and Hepatology Jul 04, 2020

Tang RSY, Kyaw MH, Teoh AYB, et al. - Researchers compared results in hepatocellular carcinoma (HCC) patients who had secondary prophylaxis (SP) of variceal rebleeding by EUS‐guided cyanoacrylate obturation (EUS‐CYA) vs no SP. Experts prospectively recruited 30 consecutive patients with inoperable HCC and recent endoscopically controlled variceal bleeding, from 2014 to 2018. EUS‐CYA for SP was received by 27 patients with persistent varices ≥ 3mm on EUS. Experts selected 33 HCC patients managed by esophagogastroduodenoscopy (EGD) guided CYA (EGD‐CYA) alone for acute variceal bleeding between 2009‐2013 using a prospective gastrointestinal bleed registry as standard of care (SOC) controls for comparison. Overall, in patients with inoperable HCC and variceal bleeding, rebleeding rate was reduced as well as variceal bleeding‐free survival was improved with SP by EUS‐CYA vs no SP.

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