To assess the clinical value of precise endoscopic tissue glue therapy in the treatment of gastric varices (GV).

Sixty patients with gastroesophageal varices type 3 treated by endoscopic tissue glue therapy at our hospital from March 2013 to November 2019 were retrospectively analyzed. According to the difference of endoscopic treatment for GV, the patients were divided into either a precision group or a classical group, with 30 cases in each group. The chi-square test was used to compare the differences in the rates of rebleeding, acute portal vein thrombosis, complications (including ectopic embolism), and outcomes (including TIPS/ surgery and mortality) at 1, 3, and 6 months after treatment between the two groups. The t-test was used to compare the differences in GV puncture number, tissue glue dosage, and Child-Pugh score between the two groups.

There was no significant difference between the two groups in age, gender, etiology, Child-Pugh score, acute portal vein thrombosis, history of hematemesis/black stool, splenectomy, or GV combined with titanium clips (P＞0.05). The cumulative number of GV punctures and tissue glue application count in the precision group at 6 months were significantly higher than those in the classical group (9.07±3.59 vs 2.90±1.71, 9.27±4.27 vs 3.90±1.95, P＜0.01). The rates of rebleeding at 1, 3, and 6 months after treatment in the precision group were significantly lower than those of the classic group (0 vs 16.7%, 3.3% vs 36.7%, 10.0% vs 46.7%, P＜0.05). There were no statistically significant differences between the two groups in terms of Child-Pugh score, fever, acute portal vein thrombosis, ectopic embolism, death due to rebleeding, or TIPS/ surgery after treatment (6.47±1.48 vs 6.40±1.54, 10% vs 10%, 0 vs 0, 0 vs 0, 0 vs 6.7%, 0 vs 6.7%, P＞0.05).

Precise GV tissue glue treatment can reduce the rate of rebleeding and the rate of complications such as fever, acute portal vein thrombosis, and ectopic embolism while having no effect on Child-Pugh score in patients with cirrhosis.