Zeng HT, Zhang ZL, Lin XM, Peng MS, Wang LS, Xu ZL. Aluminum phosphate gel reduces early rebleeding in cirrhotic patients with gastric variceal bleeding treated with histoacryl injection therapy. World J Gastrointest Endosc 2023; 15(3): 153-162 [PMID: 37034972 DOI: 10.4253/wjge.v15.i3.153]
Corresponding Author of This Article
Zheng-Lei Xu, MD, Chief Doctor, Department of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, No. 1017 Dongmen North Road, Shenzhen 518000, Guangdong Province, China. 78249073@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hao-Tian Zeng, Zhu-Liang Zhang, Xi-Min Lin, Min-Si Peng, Department of Gastroenterology, The Second Clinical Medical College, Jinan University, Shenzhen 518000, Guangdong Province, China
Li-Sheng Wang, Zheng-Lei Xu, Department of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, Shenzhen 518000, Guangdong Province, China
Author contributions: Xu ZL conceived the idea for the manuscript; Zeng HT and Zhang ZL contributed equally to this study, are considered as co-first authors, and wrote the first draft of the manuscript; Lin XM and Peng MS searched part of the information; Wang LS reviewed and revised the manuscript.
Supported byClinical Research and Cultivation Project of Shenzhen People's Hospital, No. SYLCYJ202116.
Institutional review board statement: The study was reviewed and approved by the Medical Ethics Committee of Shenzhen Municipal People's Hospital Institutional Review Board (Approval No. 20150108).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There is no any conflict-of-interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zheng-Lei Xu, MD, Chief Doctor, Department of Gastroenterology, Shenzhen People’s Hospital, The Second Clinical Medical College, Jinan University, No. 1017 Dongmen North Road, Shenzhen 518000, Guangdong Province, China. 78249073@qq.com
Received: November 9, 2022 Peer-review started: November 9, 2022 First decision: November 22, 2022 Revised: November 26, 2022 Accepted: March 1, 2023 Article in press: March 1, 2023 Published online: March 16, 2023 Processing time: 126 Days and 16.9 Hours
ARTICLE HIGHLIGHTS
Research background
The incidence of early rebleeding after endoscopic variceal histoacryl injection therapy (EVHT) of varicose veins in the fundus of the stomach is high, which may lead to serious consequences. It is very important to reduce the incidence of early rebleeding.
Research motivation
Reducing the incidence of early rebleeding after EVHT treatment reduces the risk of patients and may extend their life expectancy. Proton pump inhibitor (PPI) treatment has been found to reduce the incidence of early rebleeding. Aluminium phosphate gel (APG) can promote the healing of gastric ulcers. Can the combination of APG and PPI further reduce the incidence of early rebleeding?
Research objectives
This study aimed to verify whether the combination of APG and PPI can reduce the incidence of early rebleeding after EVHT.
Research methods
We randomly divided patients after EVHT into two groups. One group was treated on PPI after EVHT, and the other group took PPI in combination with APG. We statistically analyzed the data of both groups and observed the early rebleeding rates in both groups.
Research results
The early rebleeding rate in PPI + APG group was 3.16% (3/95), which was much lower than that in the PPI group (12.87%, 13/101). Causes of early rebleeding: The incidence of gastric ulcer bleeding in the PPI + APG group was 2.11% (2/95), which was reduced in comparison to that in the PPI group (11.88%, 12/101); the incidence of venous bleeding in PPI + APG group and PPI group was 1.05% (1/95) and 0.99% (1/101), respectively, and there was no significant difference between them. The incidence of abdominal pain in the PPI + APG group was 3.16% (3/95), which was lower than that in the PPI group (11.88%, 12/101).
Research conclusions
PPI combined with APG can significantly reduce the incidence of early rebleeding and postoperative abdominal pain in cirrhotic patients with GVB after taking EVHT.
Research perspectives
The combination of APG with PPI can reduce the bleeding incidence of gastric ulcers after EVHT.
