中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 42 Issue 9
Sep.  2026
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2026  >  42(9): 2135-2142

Efficacy and safety of two endoscopic ultrasound‑guided techniques for paraesophageal variceal puncture and selective tissue adhesive sealing: A comparative study

DOI: 10.12449/JCH260918

  • Department of Gastroenterology，Beijing Ditan Hospital，Capital Medical University，Beijing 100015，China

Research funding:

Beijing Research Ward Project - Parallel Project for Excellent Clinical Research (BRWEP2024W102170111)

More Information
  • Corresponding author: Li Ping， endolp@126.com （ORCID： 0000-0003-4579-7984）
  • Received Date: 2026-02-04
  • Accepted Date: 2026-04-30
  • Published Date: 2026-09-25
    Abstract
  •   Objective  To compare the application value of two endoscopic ultrasound （EUS）-guided targeted vascular embolization techniques in secondary prevention of esophagogastric variceal bleeding （EGVB）， and to clarify the clinical advantages of targeted main trunk embolization.  Methods  A retrospective analysis was performed for 59 patients who were admitted to Beijing Ditan Hospital， Capital Medical University， from April 2023 to July 2024 and received secondary prevention of gastroesophageal varices （GOV）-type EGVB， and according to the surgical procedure， they were divided into EUS-PCSS targeting the distal segment of the source vessel or perforating branch vessels （EUS-PCSS-D/P） group with 29 patients and EUS-PCSS targeting the source vascular trunk （EUS-PCSS-T） group with 30 patients. The two groups were observed in terms of rebleeding rate， variceal eradication efficiency， and the incidence rate of adverse events. The t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups； the Mann-Whitney U test was used for subgroup analysis， and ordinal Logistic regression was used for multivariate analysis.  Results  There were no significant differences in baseline data between the two groups （all P>0.05）. Compared with the EUS-PCSS-D/P group， the EUS-PCSS-T group had a significantly smaller diameter of punctured vessels （5.39±2.03 mm vs 7.00±2.21 mm， t=3.012， P=0.005）， a significantly lower treatment rate of supplementary endoscopic injection sclerotherapy （EIS） （40.00% vs 79.31%， χ2=7.521， P=0.006）， and a significantly lower amount of lauromacrogol used （16.08±7.25 mL vs 22.17±6.83 mL， t=2.518， P=0.015）， and there were no significant differences between the two groups in the amount of tissue adhesive used， the number of puncture sites， and treatment costs （all P>0.05）. There were no significant differences between the two groups in rates of GOV-related and all-cause gastrointestinal rebleeding （all P>0.05）. Compared with the EUS-PCSS-D/P group， the EUS-PCSS-T group had a significantly lower number of treatment sessions required for GOV eradication （2.00 ［1.25 — 2.00］ vs 3.00 ［2.00 — 4.00］， Z=3.872， P<0.001）， with a higher two-session eradication rate （50.00% vs 17.86%， χ2=7.102， P=0.008） and a lower eradication rate for three or more sessions （23.33% vs 71.43%， χ2=15.326， P<0.001）. The subgroup analysis showed that history of endoscopic treatment and supplementary EIS did not affect the number of treatment sessions required for GOV regression （all P>0.05）， and the ordinal Logistic regression analysis showed that treatment grouping was an independent influencing factor for the number of treatment sessions required for GOV regression （odds ratio=0.32， 95% confidence interval： 0.15 — 0.68， P=0.007）. There was no significant difference in the incidence rate of adverse events between the two groups （P>0.05）， and no ectopic embolism was observed in the EUS-PCSS-T group.  Conclusion  The EUS-PCSS-T procedure can significantly improve the eradication efficiency of GOV and reduce the number of treatment sessions； its efficacy is not affected by history of endoscopic treatment or supplementary EIS therapy， and it has a favorable safety profile.

     

    • FullText(HTML)
  • loading
    • References(18)
  • [1]
    Li B B, Li Y, Peng Y, et al. Visual prediction models for predicting rebleeding events after the first esophageal variceal ligation[J]. Surg Endosc, 2025, 39( 6): 3576- 3586. DOI: 10.1007/s00464-025-11714-4.
    [2]
    Shi Yan, Chen Shurong, Zhou Dan, et al. Analysis of risk factors for short-term rebleeding after initial endoscopic treatment of first rupture of esophagogastric varices[J]. Zhejiang Clin Med J, 2021, 23( 10): 1457- 1459.

    施言, 陈数荣, 周丹, 等. 内镜下治疗食管胃底静脉曲张首次破裂出血后近期再出血的危险因素分析[J]. 浙江临床医学, 2021, 23( 10): 1457- 1459.
    [3]
    Tang R S Y, Kyaw M H, Teoh A Y B, et al. Endoscopic ultrasound-guided cyanoacrylate injection to prevent rebleeding in hepatocellular carcinoma patients with variceal hemorrhage[J]. J Gastroenterol Hepatol, 2020, 35( 12): 2192- 2201. DOI: 10.1111/jgh.15168.
    [4]
    O’Rourke J, Todd A, Shekhar C, et al. EUS-guided thrombin injection and coil implantation for gastric varices: Feasibility, safety, and outcomes[J]. Gastrointest Endosc, 2024, 100( 3): 549- 556. DOI: 10.1016/j.gie.2024.01.044.
    [5]
    Bazarbashi A N, Aby E S, Mallery J S, et al. EUS-guided coil injection therapy in the management of gastric varices: The first U.S. multicenter experience(with video)[J]. Gastrointest Endosc, 2024, 99( 1): 31- 37. DOI: 10.1016/j.gie.2023.07.043.
    [6]
    Samanta J, Nabi Z, Facciorusso A, et al. EUS-guided coil and glue injection versus endoscopic glue injection for gastric varices: International multicentre propensity-matched analysis[J]. Liver Int, 2023, 43( 8): 1783- 1792. DOI: 10.1111/liv.15630.
    [7]
    He Lingling, Lin Yijun, Ye Xiaohui, et al. Efficacy of endoscopic ultrasound-guided paraesophageal varices puncture cyanoacrylate selective seal for liver cirrhosis complicated with esophageal varices(with video)[J]. Chin J Dig Endosc, 2025, 42( 7): 565- 568. DOI: 10.3760/cma.j.cn321463-20240624-00212.

    何玲玲, 林毅军, 叶小慧, 等. 超声内镜引导下食管外侧支静脉穿刺组织胶选择性封闭术治疗肝硬化伴食管静脉曲张的有效性(含视频)[J]. 中华消化内镜杂志, 2025, 42( 7): 565- 568. DOI: 10.3760/cma.j.cn321463-20240624-00212.
    [8]
    Ma Jiali, He Lingling, Wei Hongshan, et al. Safety and efficacy of puncture cyanoacrylate selective seal under endoscopic ultrasound versus traditional endoscopy in treatment of gastroesophageal varices: A randomized controlled trial[J]. J Clin Hepatol, 2025, 41( 6): 1113- 1119. DOI: 10.12449/JCH250617.

    马佳丽, 何玲玲, 魏红山, 等. 超声内镜下选择性食管胃静脉曲张来源支穿刺组织胶封闭术与传统内镜治疗的随机对照研究[J]. 临床肝胆病杂志, 2025, 41( 6): 1113- 1119. DOI: 10.12449/JCH250617.
    [9]
    Sarin S K, Lahoti D, Saxena S P, et al. Prevalence, classification and natural history of gastric varices: A long-term follow-up study in 568 portal hypertension patients[J]. Hepatology, 1992, 16( 6): 1343- 1349. DOI: 10.1002/hep.1840160607.
    [10]
    Wang Z H, Zeng Z, Chen L H, et al. Endoscopic ultrasonography-guided injection of cyanoacrylate in the treatment of gastroesophageal varices type 1: A single-center randomized study[J]. Surg Endosc, 2023, 37( 11): 8277- 8284. DOI: 10.1007/s00464-023-10342-0.
    [11]
    Sabry F, Seif S, Eldesoky A, et al. EUS-guided cyanoacrylate injection into the perforating vein versus direct endoscopic injection in the treatment of gastric varices[J]. Endosc Int Open, 2023, 11( 2): E202- E210. DOI: 10.1055/a-1984-7070.
    [12]
    Li Xinhui, Qi Xingshun, Wang Jing, et al. Construction and optimization of quality control system for endoscopic management of esophageal and gastric varices in liver cirrhosis[J]. Clin J Med Off, 2026, 54( 1): 1- 5, 10. DOI: 10.16680/j.1671-3826.2026.01.01.

    李鑫会, 祁兴顺, 王静, 等. 肝硬化食管胃静脉曲张内镜管理质量控制体系构建与优化[J]. 临床军医杂志, 2026, 54( 1): 1- 5, 10. DOI: 10.16680/j.1671-3826.2026.01.01.
    [13]
    Zhang Shuai, Zhang Xiaobin, Liu Yingdi, et al. Endoscopic management of esophagogastric varices in patients with liver cirrhosis[J/CD]. Chin J Gastrointest Endosc Electron Ed, 2024, 11( 3): 191- 194. DOI: 10.3877/cma.j.issn.2095-7157.2024.03.010.

    张帅, 张晓彬, 刘迎娣, 等. 肝硬化食管胃静脉曲张的内镜管理[J/CD]. 中华胃肠内镜电子杂志, 2024, 11( 3): 191- 194. DOI: 10.3877/cma.j.issn.2095-7157.2024.03.010.
    [14]
    Bhat Y M, Weilert F, Fredrick R T, et al. EUS-guided treatment of gastric fundal varices with combined injection of coils and cyanoacrylate glue: A large U.S. experience over 6 years(with video)[J]. Gastrointest Endosc, 2016, 83( 6): 1164- 1172. DOI: 10.1016/j.gie.2015.09.040.
    [15]
    Jhajharia A, Yadav S, Singh S, et al. Endoscopic ultrasonography-guided coil embolization and cyanoacrylate injection versus cyanoacrylate injection alone for gastric varices: A randomized comparative study[J]. Endoscopy, 2025, 57( 2): 107- 115. DOI: 10.1055/a-2408-6905.
    [16]
    Tang Yafen, Jiang Zhiyang, Long Dan, et al. Efficacy of endoscopic ultrasound-guided coil placement combined with tissue adhesive injection in treatment of gastric varices with spontaneous shunt[J]. J Clin Hepatol, 2024, 40( 4): 739- 744. DOI: 10.12449/JCH240416.

    汤雅芬, 蒋智洋, 龙丹, 等. 超声内镜引导下置入弹簧圈联合组织胶注射治疗合并自发性分流的胃静脉曲张的效果分析[J]. 临床肝胆病杂志, 2024, 40( 4): 739- 744. DOI: 10.12449/JCH240416.
    [17]
    EUS Study Group of Digestive Endoscopy Branch of Chinese Medical Association, Liver Disease Collaboration Group of Digestive Endoscopy Branch of Chinese Medical Association. Chinese expert consensus on endoscopic ultrasound-guided coil embolization for gastric varices(2025, Hangzhou)[J]. Chin J Dig Endosc, 2025, 42( 10): 757- 767. DOI: 10.3760/cma.j.cn321463-20251001-00413.

    中华医学会消化内镜学分会超声内镜学组, 中华医学会消化内镜学分会肝病协作组. 胃静脉曲张超声内镜引导弹簧圈栓塞术专家共识(2025, 杭州)[J]. 中华消化内镜杂志, 2025, 42( 10): 757- 767. DOI: 10.3760/cma.j.cn321463-20251001-00413.
    [18]
    Bang J Y, Al-Haddad M A, Chiorean M V, et al. Mo1485 comparison of direct endoscopic injection(DEI) and EUS-guided fine needle injection(EUS-FNI) of 2-octyl-cyanoacrylate for treatment of gastric varices[J]. Gastrointest Endosc, 2015, 81( 5): AB437. DOI: 10.1016/j.gie.2015.03.815.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(6)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (103) PDF downloads(43) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return