[Endoscopic obturation of esophagogastric varices with bucrylate. I. Clinical study of 49 patients].

The authors report the results of endoscopic obliteration of recently bleeding esophagogastric varices with Bucrylate (isobutyl-2-cyanoacrylate) in 49 patients. Forty-five patients had cirrhosis; in all patients, propranolol was contraindicated or had failed, hepatocellular function was poor, or early rebleeding had occurred. In 15 cases, injections were made during active bleeding of esophageal or gastric varices; in 14 cases, the hemorrhage stopped immediately. The cumulative percentages of patients free of variceal rebleeding 1.6 and 12 months after inclusion were 88.63 and 58 p. 100 respectively. The cumulative percentages of patients surviving 1, 12 and 18 months after inclusion were 70, 53 and 46 p. 100 respectively. The cumulative percentages of survival at 6 months after inclusion were 100.63 and 13 p. 100 in grade A, B and C patients respectively. The major causes of death were liver failure and sepsis; autopsy revealed mediastinitis in 3 patients. Long-lasting esophageal strictures developed in two patients. This procedure differs from endoscopic sclerotherapy in that gastric varices can be adequately obliterated and the risk of early rebleeding seems to be decreased.