Abstract | BACKGROUND: Transjugular intrahepatic portosystemic shunt ( TIPS) with adjunctive embolotherapy has recently been reported to be effective in the prevention of variceal hemorrhage of cirrhotic patients. However, further investigation of its long-term efficacy is still needed. AIM: METHODS: Patients with refractory to endoscopic therapy for esophageal variceal bleeding were enrolled. TIPS was performed in 101 patients with adjunctive embolotherapy (n = 53) or alone (n = 48) between January 2006 and December 2011. Chart reviews were performed to determine rebleeding, survival rates, and the incidence of HE. RESULTS: Recurrent hemorrhage occurred in 12 (11.9 %) patients during the mean follow-up periods of 35.8 months. Rebleeding was observed in 9/48 (18.8 %) patients in TIPS alone group and 3/53 (5.7 %) patients in TIPS with adjunctive embolotherapy group (p = 0.042). Death occurred in 30 patients during follow-up ( TIPS alone: n = 16, TIPS with adjunctive embolotherapy: n = 14, p = 0.447). Twenty-six episodes of HE occurred in 18 patients in TIPS alone group and 16 episodes occurred in 10 patients in TIPS with embolotherapy group. The probability of HE was significantly higher in TIPS alone group than in TIPS with embolotherapy group (p = 0.019). CONCLUSIONS:
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Authors | Yongjun Shi, Xiangguo Tian, Jinhua Hu, Junyong Zhang, Chunqing Zhang, Yongqing Yang, Chengyong Qin |
Journal | Digestive diseases and sciences
(Dig Dis Sci)
Vol. 59
Issue 9
Pg. 2325-32
(Sep 2014)
ISSN: 1573-2568 [Electronic] United States |
PMID | 24748182
(Publication Type: Journal Article)
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Chemical References |
- Cyanoacrylates
- Tissue Adhesives
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Topics |
- Adult
- Combined Modality Therapy
- Cyanoacrylates
(therapeutic use)
- Embolization, Therapeutic
(adverse effects)
- Esophageal and Gastric Varices
(etiology, therapy)
- Female
- Gastrointestinal Hemorrhage
(etiology, therapy)
- Hepatic Encephalopathy
(etiology)
- Humans
- Liver Cirrhosis
(complications)
- Male
- Middle Aged
- Portasystemic Shunt, Transjugular Intrahepatic
(adverse effects)
- Recurrence
- Retrospective Studies
- Survival Rate
- Tissue Adhesives
(therapeutic use)
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