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transjugular intrahepatic portosystemic shunt vs endoscopic therapy in preventing variceal rebleeding

World Journal of Gastroenterology 2012年第48期18卷 7341-7347页

作者： Hui Xue Meng Zhang Jack XQ Pang Fei Yan Ying-Chao Li Liang-Shan Lv Jia Yuan Muna Palikhe Wei-Zhi Li Zhi-Lun Wang Department of Gastroenterology First Affiliated Hospital of Xi'an Jiaotong University Department of Gastroenterology Central Hospital of Nanyang City Faculty of Public Health School of MedicineXi' an Jiaotong University

AIM:To compare early use of transjugular intrahepatic portosystemic shunt(TIPS) with endoscopic treatment(ET) for the prophylaxis of recurrent variceal ***:In-patient data were collected from 190 patients between January 2007 and June 2010 who suffured from variceal *** who were older than 75 years;previously received surgical treatment or endoscopic therapy for variceal bleeding;and complicated with hepatic encephalopathy or hepatic cancer,were excluded from this ***-five cases lost to follow-up were also *** analysis was done in 126 eligible *** them,64 patients received TIPS(TIPS group) while 62 patients received endoscopic therapy(ET group).The relevant data were collected by patient review or telephone *** occurrence of rebleeding,hepatic encephalopathy or other complications,survival rateand cost of treatment were compared between the two ***:During the follow-up period(median,20.7 and 18.7 mo in TIPS and ET groups,respectively),rebleeding from any source occurred in 11 patients in the TIPS group as compared with 31 patients in the ET group(Kaplan-Meier analysis and log-rank test,P = 0.000).rebleeding rates at any time point(6 wk,1 year and 2 year) in the TIPS group were lower than in the ET group(Bonferroni correction α' = α/3).Eight patients in the TIPS group and 16 in the ET group died with the cumulative survival rates of 80.6% and 64.9%(Kaplan-Meier analysis and log-rank test c2 = 4.864,P = 0.02),*** was no significant difference between the two groups with respect to 6-wk survival rates(Bonferroni correction α' = α/3).However,significant differences were observed between the two groups in the 1-year survival rates(92% and 79%) and the 2-year survival rates(89% and 64.9%)(Bonferroni correction α' = α/3).No significant differences were observed between the two treatment groups in the occurrence of hepatic encephalopathy(12 patients in TIPS group and 5 in ET gr

关键词： transjugular intrahepatic portosystemic shunt portal hypertension rebleeding endoscopicvariceal ligation cyanoacrylate

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