Comparison on the long?term curative effect of transjugular intrahepatic portosystemic shunt and endoscopic cyanoacrylate injection for gastric variceal bleeding
10.3760/cma.j.issn.1007-5232.2018.02.006
- VernacularTitle:经颈静脉肝内门体支架分流术和内镜下组织胶注射术治疗胃底静脉曲张破裂出血的远期疗效比较
- Author:
Yulong GUAN
1
,
2
;
Derun KONG
;
Le ZHANG
;
Jing LI
Author Information
1. 230022 合肥,安徽医科大学第一附属医院消化内科
2. 安徽省蚌埠市第三人民医院消化内科
- Keywords:
Liver cirrhosis;
Hypertension;
portal;
Transjugular intrahepatic portosystemic shunt;
Endoscopic gastric variceal obturation
- From:
Chinese Journal of Digestive Endoscopy
2018;35(2):105-109
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the long?term efficacy of transjugular intrahepatic portosystemic shunt(TIPS)for gastric variceal bleeding. Methods A retrospective analysis was performed on the data of 65 cirrhotic patients with type 1 isolated gastric variceal bleeding in the First Affiliated Hospital of Anhui Medical University from January 2014 to January 2016.Patients were divided into two groups,TIPS treatment group(n=28),and gastric variceal obturation(GVO)treatment group(n=37). The long?term follow?up results of the two groups were compared. Results Operations of the two groups were succeed. Postoperative complications in the TIPS group and GVO group were 7.14%(2/28)and 13.51%(5/37), respectively, (P=0.801).Nine cases(32.14%)had mild hepatic encephalopathy in the TIPS group,and no occurred in the GVO group. During the 20.18 ± 6.90 months of follow?up in the TIPS treatment group, 2(7.14%) patients died, and the cumulative rebleeding?free rate at 6, 12 and 18 months was 88.4%, 83.7% and 76.1%,respectively.During the 16.14±6.03 months of follow?up in the GVO treatment group,5(13.51%) patients died, and the cumulative rebleeding?free rate at 6, 12 and 18 months was 86.5%, 70.2% and 60.9%,respectively. The survival rate between the two groups had no significant difference(P=0.690). There was a statistically significant difference in the cumulative non?bleeding rate in 18 months of follow up(log?rank test,χ2=6.304,P=0.012). Conclusion TIPS is superior to GVO for controlling gastric variceal bleeding in the long run,but clinicians should be vigilant to the occurrence of hepatic encephalopathy after operation.
