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Welcome to the Liver hub. On this page, you will find access to the latest liver clinical guidelines and guidance. You will also find the latest relevant news, articles and events.
You can find information on the Liver Section Committee on their page.
MHRA alert regarding N-butyl-2-cyanoacrylate (Histoacryl)
The MHRA has issued an alert regarding N-butyl-2-cyanoacrylate (Histoacryl) after being notified about problems with batches that have failed to polymerise when deployed. They have also warned of potential supply problems in the near future. Cyanoacrylate is recommended in the BSG 2015 guidelines for the management of gastric variceal haemorrhage in cirrhotic patients (level 1a, grade A). Thrombin can also be considered, albeit with a weaker evidence base (level 4, grade C). Many units around the UK already use thrombin (FlosealTM) and Endoscopy Units may wish to consider having this available as an alternative to cyanoacrylate for patients with bleeding gastric varices until the situation is resolved.
The BSG does not routinely issue drug or device alerts but in this instance, all members should be aware of the problems with Histoacryl to allow forward planning, given the often life-threatening and emergency nature of gastric variceal haemorrhage.
Ian Penman, VP Endoscopy
John Dillon, VP Hepatology
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Events & Training
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Sustainability in Gastroenterology Join us on 14th July for our webinar on Sustainability in Gastroenterology....continue reading27 May | Online Event
Endorsed Event: Current Issues and Considerations in Endoscope Decontamination
We are delighted to endorse the Current Issues and Considerations in Endoscope Decontamination virtual education...continue reading03 Jun | Online Event
