A Meta-analysis on effectiveness of different surgical procedures in treating esophageal variceal bleeding in patients with portal hypertension
10.3760/cma.j.issn.1007-8118.2017.04.005
- VernacularTitle:不同术式治疗门静脉高压症上消化道出血的效果荟萃分析
- Author:
Yi TAN
;
Mingjie DONG
;
Kai ZHU
;
Zheng LU
;
Peiyuan CUI
;
Hua WU
;
Binquan WU
;
Wei WU
;
Xiang MA
;
Wanliang SUN
;
Dengyong ZHANG
- Keywords:
Portal hypertension;
Devascularization;
Shunt;
Rebleeding;
Hepatic encephalopathy
- From:
Chinese Journal of Hepatobiliary Surgery
2017;23(4):230-234
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effectiveness of surgical procedures (devascularization,shunt and combined shunt and devascularization) in treating recurrent variceal bleeding and other complications in patients with portal hypertension.Methods A systematic literature search was carried out on patients with portal hypertension,and a Meta-analysis was conducted using Revman 5.3 software to evaluate the effectiveness of different surgical procedures on recurrent esophageal variceal bleeding,hepatic encephalopathy,operative mortality and survival rates.Results A total of 24 trials were finally selected using predetermined inclusion criteria.Meta-analysis showed there was no significant difference among the three operations on operative mortality (P ＞ 0.05).The rebleeding rate of the combined group was significantly lower than the devascularization group (P ＜ 0.05).The encephalopathy rate of the combined group was significantly lower than the shunt group (P ＜ 0.05),and the 1-year and 3-year survival rates of the combined group were better than the devascularization group (both P ＜ 0.05),but there were no significant difference in the 5-year survival rates between these two groups (P ＞ 0.18).The 1-year and 3-year survival rates were not significantly different between the combined and the shunt groups (both P ＞ 0.05).Conclusions Combined shunt and devascularization had better therapeutic effectiveness than either devascularization alone or shunt alone in patients with portal hypertension with a high rebleeding risk.There were no significant difference among the three surgical procedures in operative mortality.The survival rates of combined surgery were significantly better than devascrlarization alone.
