Tags

Type your tag names separated by a space and hit enter

Endoscopic variceal ligation plus propranolol vs. transjugular intrahepatic portosystemic stent shunt: a long-term randomized trial.
Endoscopy. 2002 Sep; 34(9):690-7.E

Abstract

BACKGROUND AND STUDY AIMS

After a first variceal bleeding episode in patients with cirrhosis of the liver, treatment with transjugular intrahepatic portosystemic stent shunt (TIPS) and endoscopic variceal ligation (EVL) plus propranolol were compared, with regard to prevention of variceal rebleeding, complications, and mortality.

PATIENTS AND METHODS

85 patients were randomly allocated to receive TIPS (n = 43) or EVL (n = 42). The groups were comparable regarding age, sex, etiology of liver cirrhosis, and liver function.

RESULTS

The mean observation times were 4.1 years in the TIPS group and 3.6 years in the EVL group. Although the probability of rebleeding was higher in the EVL group (29.9%) than in the TIPS group (19.4%), the difference was not statistically significant. Three of five patients of the EVL group successfully underwent TIPS placement after treatment failure. The probability of TIPS dysfunction requiring shunt revision was 89 %. Hepatic encephalopathy was observed more often in the TIPS group (40.5%) than in the EVL group (20.5%; P < 0.05). The probability of survival was similar in both groups (TIPS group 75.9%, EVL group 82.2%; n.s.).

CONCLUSIONS

In view of its good efficacy and the lower cost of treatment, endoscopic ligation plus propranolol may be recommended as initial procedure for prevention of recurrent variceal hemorrhage, whereas TIPS seems to be the preferable procedure in patients with recurrent bleeding after adequate endoscopic and pharmacological treatment.

Authors+Show Affiliations

Department of Internal Medicine, University of Heidelberg, Germany. peter_sauer@med.uni-heidelberg.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

12195325

Citation

Sauer, P, et al. "Endoscopic Variceal Ligation Plus Propranolol Vs. Transjugular Intrahepatic Portosystemic Stent Shunt: a Long-term Randomized Trial." Endoscopy, vol. 34, no. 9, 2002, pp. 690-7.
Sauer P, Hansmann J, Richter GM, et al. Endoscopic variceal ligation plus propranolol vs. transjugular intrahepatic portosystemic stent shunt: a long-term randomized trial. Endoscopy. 2002;34(9):690-7.
Sauer, P., Hansmann, J., Richter, G. M., Stremmel, W., & Stiehl, A. (2002). Endoscopic variceal ligation plus propranolol vs. transjugular intrahepatic portosystemic stent shunt: a long-term randomized trial. Endoscopy, 34(9), 690-7.
Sauer P, et al. Endoscopic Variceal Ligation Plus Propranolol Vs. Transjugular Intrahepatic Portosystemic Stent Shunt: a Long-term Randomized Trial. Endoscopy. 2002;34(9):690-7. PubMed PMID: 12195325.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic variceal ligation plus propranolol vs. transjugular intrahepatic portosystemic stent shunt: a long-term randomized trial. AU - Sauer,P, AU - Hansmann,J, AU - Richter,G M, AU - Stremmel,W, AU - Stiehl,A, PY - 2002/8/27/pubmed PY - 2002/10/19/medline PY - 2002/8/27/entrez SP - 690 EP - 7 JF - Endoscopy JO - Endoscopy VL - 34 IS - 9 N2 - BACKGROUND AND STUDY AIMS: After a first variceal bleeding episode in patients with cirrhosis of the liver, treatment with transjugular intrahepatic portosystemic stent shunt (TIPS) and endoscopic variceal ligation (EVL) plus propranolol were compared, with regard to prevention of variceal rebleeding, complications, and mortality. PATIENTS AND METHODS: 85 patients were randomly allocated to receive TIPS (n = 43) or EVL (n = 42). The groups were comparable regarding age, sex, etiology of liver cirrhosis, and liver function. RESULTS: The mean observation times were 4.1 years in the TIPS group and 3.6 years in the EVL group. Although the probability of rebleeding was higher in the EVL group (29.9%) than in the TIPS group (19.4%), the difference was not statistically significant. Three of five patients of the EVL group successfully underwent TIPS placement after treatment failure. The probability of TIPS dysfunction requiring shunt revision was 89 %. Hepatic encephalopathy was observed more often in the TIPS group (40.5%) than in the EVL group (20.5%; P < 0.05). The probability of survival was similar in both groups (TIPS group 75.9%, EVL group 82.2%; n.s.). CONCLUSIONS: In view of its good efficacy and the lower cost of treatment, endoscopic ligation plus propranolol may be recommended as initial procedure for prevention of recurrent variceal hemorrhage, whereas TIPS seems to be the preferable procedure in patients with recurrent bleeding after adequate endoscopic and pharmacological treatment. SN - 0013-726X UR - https://www.unboundmedicine.com/medline/citation/12195325/Endoscopic_variceal_ligation_plus_propranolol_vs__transjugular_intrahepatic_portosystemic_stent_shunt:_a_long_term_randomized_trial_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2002-33565 DB - PRIME DP - Unbound Medicine ER -