Use of fibrin glue (beriplast) in the management of bleeding gastric varices.

BACKGROUND AND AIMS

Gastric variceal bleeding is a serious complication of portal hypertension. The optimum endoscopic treatment of bleeding gastric varices is yet to be defined. We evaluated the use of Beriplast, which is a solution of fibrinogen and thrombin, in controlling gastric variceal bleeding.

PATIENTS AND METHODS

Fifteen patients presenting with gastric variceal bleeding were entered into an open trial of endoscopic gastric intravariceal injection treatment with Beriplast (fibrin sealant) and followed for up to 1 month after endoscopic treatment.

RESULTS

There was failure to control bleeding in one patient. Four patients had rebleeding after the index bleed. All four were reinjected with Beriplast, and the bleeding was controlled in three. All patients were followed for 30 days, and the 30-day mortality following injection treatment was one. Fourteen patients were discharged from the hospital after the first episode of gastric variceal bleeding. None of the patients had injection-induced complications.

CONCLUSIONS

These results show that Beriplast is a safe and simple endoscopic treatment option and is very effective in controlling gastric variceal bleeding.