Endoscopic hemostasis with fibrin glue in the management of cirrhotic variceal bleeding
DOI:
https://doi.org/10.52556/2587-3873.2025.2(104).01Keywords:
liver cirrhosis, Variceal bleeding, Endoscopic hemostasis, fibrin glueAbstract
Variceal bleeding is a life-threatening complication of liver cirrhosis, associated with high mortality; therefore, effective endoscopic hemostasis is of paramount importance. The aim of the study was to evaluate the efficacy of endoscopic hemostasis using fibrin glue in variceal bleeding among patients with liver cirrhosis, depending on the time from bleeding onset and the level of hepatic functional reserve. The study included 463 cirrhotic patients with variceal bleeding who underwent endoscopic hemostasis using extemporaneously prepared fibrin adhesive. Based on the time from bleeding onset, patients were divided into two groups: hemostasis performed within less than 6 hours (104 patients) and more than 6 hours (359 patients) from the onset. Variceal bleeding was successfully controlled in 460 cases (99.4%). In the first group, 10 patients (9.6%) died from hemorrhagic shock, regardless of the degree of liver dysfunction. In the second group, 62 patients (17.3%) died from liver failure, with a correlation found between mortality and hepatic dysfunction. Endoscopic hemostasis using fibrin glue is an effective method for controlling variceal bleeding in cirrhotic patients. Patient survival within the first 6 hours after the onset of bleeding directly correlates with the speed of hemostasis, offering a chance of survival even for those with minimal hepatic reserve.
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