Key Laboratory of Digestive Diseases of Anhui Province, Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, 230022, Anhui, China.
Surg Endosc. 2024 Feb;38(2):633-639. doi: 10.1007/s00464-023-10532-w. Epub 2023 Nov 27.
The present study aimed to investigate the accuracy of endoscopic ultrasonography (EUS) combined with Indian ink in locating target vessels of gastric varices (GVs) compared with conventional endoscopic techniques. Additionally, the characteristics of GVs under conventional endoscopy were also explored.
All 50 cirrhotic patients with GVs between August 2021 and December 2022 were included in the study. Firstly, conventional endoscopy was employed to identify GVs and to record the expected injection sites. Subsequently, EUS was used to locate the perforated vessel and the injection site was them marked with India ink followed by injection with cyanoacrylate (CYA). Finally, conventional endoscopy was used to examine GVs, to identify the marker points of Indian ink and to compare whether the injection points under conventional endoscopy were consistent with those marked with Indian ink. Furthermore, patients with consistent and inconsistent distribution of endoscopic markers and injection sites were divided into two groups.
EUS could detect the perforating vessels in real time and intuitively. The distribution of markers using EUS was significantly different compared with the injection points obtained by conventional endoscopy (P < 0.001). Therefore, 20 cases were allocated to the consistent group and 30 cases to the non-consistent group. 16 patients who showed red wale signs were obtained in the consistent group and 11 patients in the non-consistent group (P = 0.048). The diameter of the largest GVs was 13.5 (10-15) mm in the consistent group compared with 10 (7.5-10) mm in the non-consistent group (P = 0.006).
EUS could provide the exact location of GVs, thus more accurately describing the endoscopic characteristics of the GVs. Furthermore, the red wale signs and diameter of the largest GVs obtained using conventional endoscopy were helpful in determining the location of target GVs.
本研究旨在探讨内镜超声（EUS）联合印度墨水定位胃静脉曲张（GVs）靶血管的准确性，与常规内镜技术相比。此外，还探讨了常规内镜下 GV 的特征。
2021 年 8 月至 2022 年 12 月期间，所有 50 例肝硬化伴 GV 的患者均纳入本研究。首先，采用常规内镜识别 GV，并记录预期注射部位。然后，使用 EUS 定位穿孔血管，并使用印度墨水标记注射部位，随后注射氰基丙烯酸酯（CYA）。最后，再次使用常规内镜检查 GV，识别印度墨水的标记点，并比较常规内镜下的注射点是否与印度墨水标记的注射点一致。此外，将内镜标记和注射部位分布一致和不一致的患者分为两组。
EUS 可实时直观地检测穿孔血管。EUS 标记的分布与常规内镜下获得的注射点明显不同（P<0.001）。因此，20 例患者被分配到一致组，30 例患者被分配到不一致组。在一致组中，有 16 例患者出现红色条纹征，在不一致组中，有 11 例患者出现红色条纹征（P=0.048）。在一致组中，最大 GV 的直径为 13.5（10-15）mm，而在不一致组中为 10（7.5-10）mm（P=0.006）。
EUS 可提供 GV 的准确位置，从而更准确地描述 GV 的内镜特征。此外，常规内镜下获得的红色条纹征和最大 GV 的直径有助于确定靶 GV 的位置。
