Background: The aim of the study was to investigate the effectiveness and safety of endoscopic variceal ligation (EVL) and endoscopic tissue adhesive injection (TAI) in the treatment of esophagogastric variceal bleeding (EVB). Methods: A total of 245 patients with EVB who attended the First Affiliated Hospital of Bengbu Medical College from December 2017 to June 2021 were retrospectively collected. The participants were divided into the esophageal EVL (E-EVL) + gastric EVL (G-EVL) group (n = 103) and E-EVL + gastric TAI (G-TAI) group (n = 142), according to the procedure, comparing and assessing the clinical characteristics, laboratory results, operation time, rebleeding rate, efficacy, and complications. Results: The E-EVL + G-EVL group had significantly less varicose vein diameter and operative time than the E-EVL + G-TAI group (p < 0.05). No statistical difference in the length of hospital stay between the two groups was noted (p > 0.05). The total rebleeding rate in the E-EVL + G-EVL group was 9.7%, whereas that of the E-EVL + G-TAI group was 11.9%; no statistical difference between the two groups was noted (p > 0.05). The overall effective rate of the E-EVL + G-EVL group was 90.21%, whereas that of the E-EVL + G-TAI group was 92.81%; no statistical difference between the two groups was observed (p > 0.05). The postoperative ulcer in the E-EVL + G-EVL group was smaller and more superficial than that in the E-EVL + G-TAI group, and the wound surface was smoother. Conclusion: Both EVL and TAI have good therapeutic effects on EVB. Furthermore, owing to its effectiveness in preventing rebleeding, no reduction in efficacy and no increase in complications, shortened operative time, smaller and superficial ulcer, and smoother wounds, gastric EVL is worthy of further clinical promotion.

1.
Bhardwaj
A
,
Kedarisetty
CK
,
Vashishtha
C
,
Bhadoria
AS
,
Jindal
A
,
Kumar
G
,
.
Carvedilol delays the progression of small oesophageal varices in patients with cirrhosis: a randomised placebo-controlled trial
.
Gut
.
2017
;
66
(
10
):
1838
43
.
2.
Tsauo
J
,
Noh
SY
,
Shin
JH
,
Gwon
DI
,
Han
K
,
Lee
JM
,
.
Retrograde transvenous obliteration for the prevention of variceal rebleeding in patients with portal vein thrombosis: a multicenter study
.
Eur Radiol
.
2021
;
31
(
1
):
559
66
.
3.
Garcia-Tsao
G
,
Abraldes
JG
,
Berzigotti
A
,
Bosch
J
.
Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases
.
Hepatology
.
2017
;
65
(
1
):
310
35
.
4.
Seo
YS
.
Prevention and management of gastroesophageal varices
.
Clin Mol Hepatol
.
2018
;
24
(
1
):
20
42
.
5.
Ali
SM
,
Wu
S
,
Xu
H
,
Liu
H
,
Hao
J
,
Qin
C
.
A prospective study of endoscopic injection sclerotherapy and endoscopic variceal ligation in the treatment of esophageal varices
.
J Laparoendosc Adv Surg Tech A
.
2017
;
27
(
4
):
333
41
.
6.
Tripathi
D
,
Stanley
AJ
,
Hayes
PC
,
Patch
D
,
Millson
C
,
Mehrzad
H
,
.
U.K. guidelines on the management of variceal haemorrhage in cirrhotic patients
.
Gut
.
2015
;
64
(
11
):
1680
704
.
7.
Bai
XL
,
Yang
LY
.
Expert consensus on diagnosis and treatment of esophagogastric variceal bleeding in cirrhotic portal hypertension (2019 edition)
.
Chin J Dig Surg
.
2019
;(
12
):
1087
93
.
8.
Lo
GH
,
Lin
CW
,
Perng
DS
,
Chang
CY
,
Lee
CT
,
Hsu
CY
,
.
A retrospective comparative study of histoacryl injection and banding ligation in the treatment of acute type 1 gastric variceal hemorrhage
.
Scand J Gastroenterol
.
2013
;
48
(
10
):
1198
204
.
9.
Liu
C
,
Ma
L
,
Wang
J
,
Li
F
,
Tseng
Y
,
Luo
T
,
.
Prophylactic use of antibiotics in endoscopic injection of tissue adhesive for the elective treatment of gastric varices: a randomized controlled study
.
J Gastroenterol Hepatol
.
2019
;
34
(
9
):
1486
91
.
10.
Dong
XJ
,
Chen
WQ
.
Therapeutic efficacy of endoscopic variceal ligation to treat gastric varices: a study of 63 consecutive cases
.
Chin J Hepatol
.
2013
;
21
(
9
):
692
6
.
11.
Lesmana
CRA
,
Raharjo
M
,
Gani
RA
.
Managing liver cirrhotic complications: overview of esophageal and gastric varices
.
Clin Mol Hepatol
.
2020
;
26
(
4
):
444
60
.
12.
Sarin
SK
,
Lahoti
D
,
Saxena
SP
,
Murthy
NS
,
Makwana
UK
.
Prevalence, classification and natural history of gastric varices: a long-term follow-up study in 568 portal hypertension patients
.
Hepatology
.
1992
;
16
(
6
):
1343
9
.
13.
Li
Z
,
LiHu
E
,
DU
H
,
Wang
H
,
Meng
J
,
Wang
X
.
Feasibility study of measuring simulated esophageal varices in vitro with esophageal varices diameter measuring ruler
.
Chin J Laparosc Surg
.
2011
;
4
(
5
):
402
4
.
14.
Wani
ZA
,
Bhat
RA
,
Bhadoria
AS
,
Maiwall
R
,
Choudhury
A
.
Gastric varices: classification, endoscopic and ultrasonographic management
.
J Res Med Sci
.
2015
;
20
(
12
):
1200
7
.
15.
Elsebaey
MA
,
Tawfik
MA
,
Ezzat
S
,
Selim
A
,
Elashry
H
,
Abd-Elsalam
S
.
Endoscopic injection sclerotherapy versus N-Butyl-2 Cyanoacrylate injection in the management of actively bleeding esophageal varices: a randomized controlled trial
.
BMC Gastroenterol
.
2019
;
19
(
1
):
23
.
16.
Shiha
G
,
El-Sayed
SS
.
Gastric variceal ligation: a new technique
.
Gastrointest Endosc
.
1999
;
49
(
4 Pt 1
):
437
41
.
17.
de Franchis
R
;
Baveno V Faculty
.
Revising consensus in portal hypertension: report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension
.
J Hepatol
.
2010
;
53
(
4
):
762
8
.
18.
Krige
J
,
Jonas
E
,
Kotze
U
,
Kloppers
C
,
Gandhi
K
,
Allam
H
,
.
Defining the advantages and exposing the limitations of endoscopic variceal ligation in controlling acute bleeding and achieving complete variceal eradication
.
World J Gastrointest Endosc
.
2020
;
12
(
10
):
365
77
.
19.
Cho
E
,
Jun
CH
,
Cho
SB
,
Park
CH
,
Kim
HS
,
Choi
SK
,
.
Endoscopic variceal ligation-induced ulcer bleeding: what are the risk factors and treatment strategies
.
Medicine
.
2017
;
96
(
24
):
e7157
.
20.
Xiaoqing
Z
,
Na
L
,
Lili
M
,
Jie
C
,
Tiancheng
L
,
Jian
W
,
.
Endoscopic cyanoacrylate injection with lauromacrogol for gastric varices: long-term outcomes and predictors in a retrospective cohort study
.
J Laparoendosc Adv Surg Tech A
.
2019
;
29
(
9
):
1135
43
.
21.
Hu
Z
,
Zhang
D
,
Swai
J
,
Liu
T
,
Liu
S
.
Risk of rebleeding from gastroesophageal varices after initial treatment with cyanoacrylate: a systematic review and pooled analysis
.
BMC Gastroenterol
.
2020
;
20
(
1
):
181
.
22.
Lo
GH
,
Lin
CW
,
Tai
CM
,
Perng
DS
,
Chen
IL
,
Yeh
JH
,
.
A prospective, randomized trial of thrombin versus cyanoacrylate injection in the control of acute gastric variceal hemorrhage
.
Endoscopy
.
2020
;
52
(
7
):
548
55
.
23.
Jakab
SS
,
Garcia-Tsao
G
.
Evaluation and management of esophageal and gastric varices in patients with cirrhosis
.
Clin Liver Dis
.
2020
;
24
(
3
):
335
50
.
24.
Hong
HJ
,
Jun
CH
,
Lee
DH
,
Cho
EA
,
Park
SY
,
Cho
SB
,
.
Comparison of endoscopic variceal ligation and endoscopic variceal obliteration in patients with GOV1 bleeding
.
Chonnam Med J
.
2013
;
49
(
1
):
14
9
.
25.
El Amin
H
,
Abdel Baky
L
,
Sayed
Z
,
Abdel Mohsen
E
,
Eid
K
,
Fouad
Y
,
.
A randomized trial of endoscopic variceal ligation versus cyanoacrylate injection for treatment of bleeding junctional varices
.
Trop Gastroenterol
.
2010
;
31
(
4
):
279
84
.
26.
Bai
DS
,
Jin
SJ
,
Xiang
XX
,
Qian
JJ
,
Zhang
C
,
Zhou
BH
,
.
Vagus nerve-preserving laparoscopic splenectomy and azygoportal disconnection with versus without intraoperative endoscopic variceal ligation: a randomized clinical trial
.
J Gastrointest Surg
.
2022
;
26
(
9
):
1838
45
.
27.
Lo
GH
,
Lai
KH
,
Cheng
JS
,
Chen
MH
,
Chiang
HT
.
A prospective, randomized trial of butyl cyanoacrylate injection versus band ligation in the management of bleeding gastric varices
.
Hepatology
.
2001
;
33
(
5
):
1060
4
.
28.
Tan
PC
,
Hou
MC
,
Lin
HC
,
Liu
TT
,
Lee
FY
,
Chang
FY
,
.
A randomized trial of endoscopic treatment of acute gastric variceal hemorrhage: N-butyl-2-cyanoacrylate injection versus band ligation
.
Hepatology
.
2006
;
43
(
4
):
690
7
.
29.
Tantau
M
,
Crisan
D
,
Popa
D
,
Vesa
S
,
Tantau
A
.
Band ligation vs. N-Butyl-2-cyanoacrylate injection in acute gastric variceal bleeding: a prospective follow-up study
.
Ann Hepatol
.
2014
;
13
(
1
):
75
83
.
30.
Wang
J
,
Chen
S
,
Naga
YM
,
Liu
J
,
Dai
M
,
Yang
S
,
.
Esophageal variceal ligation monotherapy versus combined ligation and sclerotherapy for the treatment of esophageal varices
.
Can J Gastroenterol Hepatol
.
2021
;
2021
:
8856048
.
31.
Liu
B
,
Li
G
.
Progress in endoscopic and interventional treatment of esophagogastric variceal bleeding
.
Dis Markers
.
2022
;
2022
:
2940578
.
You do not currently have access to this content.