N-butyl-2-cyanoacrylate (Histoacryl) plus sclerotherapy versus sclerotherapy alone in the treatment of bleeding esophageal varices: a randomized prospective study.

Background And Study Aims: N-2-cyanoacrylate (Histoacryl) and endoscopic sclerotherapy with polidocanol have both been reported to control variceal bleeding. The aim of the present study was to compare the effectiveness of the combination of Histoacryl and endoscopic sclerotherapy with polidocanol in the management of these patients regarding early rebleeding and hospital mortality rates.

Patients And Methods: One hundred twenty-six consecutive patients with variceal hemorrhage treated with injection therapy between March 1990 and July 1993 were included in this randomized prospective study.

Laparoscopic transcystic papillotomy under endoscopic control for bile duct stones.

We present here a laparoscopic transcystic papillotomy technique for the management of bile duct stones discovered either preoperatively or on intraoperative cholangiogram. Papillotomy is performed orthogradely with a hydrophilic wire-guided spincterotome inserted through the cystic duct. The correct position of the diathermic wire is verified with peroral duodenoscopy.