Abstract
OBJECTIVE: To assess whether Histoacryl injection with clips is superior to Histoacryl injection alone in terms of efficacy and safety. METHODS: Patients with gastric varices who were admitted to our Department and received Histoacryl injection or Histoacryl injection with clips between January 2019 and December 2024 were enrolled. Patients were followed up, and data of patients were collected. Propensity score matching was used to match the variables between the two groups. Post-operative bleeding and adverse events between the two groups were compared. RESULTS: A total of 148 patients with gastric varices were enrolled in the study, 139 patients completed follow up and were included in the final analysis, among them, 116 patients in the Histoacryl injection alone group and 23 patients in the clip-assisted Histoacryl injection group. After propensity score matching, 92 patients were successfully matched, 23 patients in the clip-assisted Histoacryl injection group and 69 patients in the Histoacryl injection alone group. There were significantly more early post-operative bleeding episodes in the Histoacryl injection alone group than the clip-assisted Histoacryl injection group, there was no significant difference in terms of late post-operative bleeding, as well as abdominal pain and fever. CONCLUSIONS: Histoacryl injection with clips has lower early post-operative bleeding rate, without more adverse events. Histoacryl injection with clips may be preferred as an endoscopic treatment, especially for patients with larger gastric varices.