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Transjugular intrahepatic portosystemic shunt in the treatment of refractory bleeding from ruptured gastric varices.
Hepatology. 1999 Nov; 30(5):1139-43.Hep

Abstract

The optimal management of ruptured gastric varices in patients with cirrhosis has not been codified yet. The present study reports the use of transjugular intrahepatic portosystemic shunt (TIPS) in patients with refractory gastric variceal bleeding. Thirty-two consecutive patients were included. All had been unresponsive to vasoactive agents infusion, sclerotherapy, and/or tamponade and were considered poor surgical candidates. They were followed-up until death, transplantation, or at least 1 year (median: 509 days; range 4 to 2,230). Hemostasis was achieved in 18 out of 20 patients actively bleeding at the time of the procedure. In the whole sample of 32 patients, rebleeding rates were 14%, 26%, and 31%, respectively at 1 month, 6 months, and 1 year. De novo encephalopathy was observed in 5 (16%) patients. Seven patients experienced complications and consequently 4 of these patients died. TIPS primary patency rates were 84%, 74%, and 51%, respectively, at 1 month, 6 months, and 1 year. For the same periods of time, survival rates were 75%, 62%, and 59%. These results suggest that TIPS can be used in cirrhotic patients with refractory gastric variceal bleeding and are effective in achieving hemostasis as well as in preventing rebleeding.

Authors+Show Affiliations

Service d'Hépato-Gastro-Entérologie, Fédération Digestive, CHU Purpan, Toulouse, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10534333

Citation

Barange, K, et al. "Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Refractory Bleeding From Ruptured Gastric Varices." Hepatology (Baltimore, Md.), vol. 30, no. 5, 1999, pp. 1139-43.
Barange K, Péron JM, Imani K, et al. Transjugular intrahepatic portosystemic shunt in the treatment of refractory bleeding from ruptured gastric varices. Hepatology. 1999;30(5):1139-43.
Barange, K., Péron, J. M., Imani, K., Otal, P., Payen, J. L., Rousseau, H., Pascal, J. P., Joffre, F., & Vinel, J. P. (1999). Transjugular intrahepatic portosystemic shunt in the treatment of refractory bleeding from ruptured gastric varices. Hepatology (Baltimore, Md.), 30(5), 1139-43.
Barange K, et al. Transjugular Intrahepatic Portosystemic Shunt in the Treatment of Refractory Bleeding From Ruptured Gastric Varices. Hepatology. 1999;30(5):1139-43. PubMed PMID: 10534333.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transjugular intrahepatic portosystemic shunt in the treatment of refractory bleeding from ruptured gastric varices. AU - Barange,K, AU - Péron,J M, AU - Imani,K, AU - Otal,P, AU - Payen,J L, AU - Rousseau,H, AU - Pascal,J P, AU - Joffre,F, AU - Vinel,J P, PY - 1999/10/26/pubmed PY - 1999/10/26/medline PY - 1999/10/26/entrez SP - 1139 EP - 43 JF - Hepatology (Baltimore, Md.) JO - Hepatology VL - 30 IS - 5 N2 - The optimal management of ruptured gastric varices in patients with cirrhosis has not been codified yet. The present study reports the use of transjugular intrahepatic portosystemic shunt (TIPS) in patients with refractory gastric variceal bleeding. Thirty-two consecutive patients were included. All had been unresponsive to vasoactive agents infusion, sclerotherapy, and/or tamponade and were considered poor surgical candidates. They were followed-up until death, transplantation, or at least 1 year (median: 509 days; range 4 to 2,230). Hemostasis was achieved in 18 out of 20 patients actively bleeding at the time of the procedure. In the whole sample of 32 patients, rebleeding rates were 14%, 26%, and 31%, respectively at 1 month, 6 months, and 1 year. De novo encephalopathy was observed in 5 (16%) patients. Seven patients experienced complications and consequently 4 of these patients died. TIPS primary patency rates were 84%, 74%, and 51%, respectively, at 1 month, 6 months, and 1 year. For the same periods of time, survival rates were 75%, 62%, and 59%. These results suggest that TIPS can be used in cirrhotic patients with refractory gastric variceal bleeding and are effective in achieving hemostasis as well as in preventing rebleeding. SN - 0270-9139 UR - https://www.unboundmedicine.com/medline/citation/10534333/Transjugular_intrahepatic_portosystemic_shunt_in_the_treatment_of_refractory_bleeding_from_ruptured_gastric_varices_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0270913999004711 DB - PRIME DP - Unbound Medicine ER -