Ye Ye, Liu Luojie, Xu Liansheng
Department of Gastroenterology, Changshu Hospital Affiliated to Soochow University, Suzhou, China.
Surg Endosc. 2025 May;39(5):3155-3166. doi: 10.1007/s00464-025-11702-8. Epub 2025 Apr 8.
This study aims to preliminarily investigate the therapeutic effect of cyanoacrylate glue (CG) on Forrest IIa and IIb peptic ulcer hemorrhage (PCH).
From January 2020 to May 2024, we retrospectively collected data on patients with Forrest IIa and IIb PCH treated with CG using emergency endoscopic hemostasis at a single center and subsequently evaluated and compared the efficacy of CG with respect to ulcer location, Forrest staging, and ulcer size.
A total of 93 patients were enrolled, achieving 100% technical success without 24-h rebleeding. The rebleeding rate at 72 h was 1.1% (95% confidence interval [CI]: 0.2-5.9%), and the rebleeding rate at 7 days was 2.2% (95% CI: 0.6-7.6%). The median age of the patients was 43.0 years. There were 42 patients (45.2%) with Forrest IIa ulcers and 51 patients (54.8%) with Forrest IIb ulcers. Sixty patients (64.5%) had ulcers ranging in size from 1.0 to 2.0 cm, while 33 patients (35.5%) had ulcers larger than 2.0 cm. The ulcers were located in the antrum (19 cases), angulus (38 cases), gastric body (11 cases), and duodenal bulb (25 cases). Median procedure time was 12.0 min, with duodenal PCH requiring significantly less time than stomach PCH (P < 0.05). CG treatment efficacy was comparable between Forrest IIa/IIb ulcers as well as across ulcer sizes (P > 0.05).
CG is particularly effective and safe for PCH located in the duodenal bulb, as well as for both Forrest IIa and IIb PCH.
本研究旨在初步探讨氰基丙烯酸酯胶（CG）对福雷斯特IIa和IIb型消化性溃疡出血（PCH）的治疗效果。
2020年1月至2024年5月，我们回顾性收集了在单一中心接受CG紧急内镜止血治疗的福雷斯特IIa和IIb型PCH患者的数据，并随后评估和比较了CG在溃疡位置、福雷斯特分级和溃疡大小方面的疗效。
共纳入93例患者，技术成功率达100%，无24小时再出血情况。72小时时再出血率为1.1%（95%置信区间[CI]：0.2 - 5.9%），7天时再出血率为2.2%（95% CI：0.6 - 7.6%）。患者的中位年龄为43.0岁。有42例（45.2%）福雷斯特IIa型溃疡患者和51例（54.8%）福雷斯特IIb型溃疡患者。60例（64.5%）患者的溃疡大小在1.0至2.0厘米之间，而33例（35.5%）患者的溃疡大于2.0厘米。溃疡位于胃窦（19例）、胃角（38例）、胃体（11例）和十二指肠球部（25例）。中位手术时间为12.0分钟，十二指肠PCH所需时间明显少于胃部PCH（P < 0.05）。CG治疗福雷斯特IIa/IIb型溃疡以及不同大小溃疡的疗效相当（P > 0.05）。
CG对于位于十二指肠球部的PCH以及福雷斯特IIa和IIb型PCH均特别有效且安全。
