Emergency Transjugular Intrahepatic Portosystemic Shunt: an Effective and Safe Treatment for Uncontrolled Variceal Bleeding

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Yongjun ZhuLi Yang

Abstract

Uncontrolled variceal bleeding (VB) remains a great challenge for clinical treatment. Emergency transjugular intrahepatic portosystemic shunt (TIPS) is a salvage procedure, but unsatisfactory clinical outcomes and a high incidence of complications have been reported. This study aimed to investigate the effect and safety of emergency TIPS performed in our institution during recent years. Fifty-eight consecutive cirrhotic patients with uncontrolled VB who underwent emergency TIPS from March 2009 to November 2017 in our hospital were followed until the last clinical evaluation, liver transplantation (LT), or death. Overall, 5, 36, and 17 patients belonged to Child-Pugh class A, B, and C, respectively. TIPS was successfully performed in 57 (98.3%) patients at 89.5 h (mean) after initial bleeding. After TIPS, bleeding ceased in 52 (91.2%) patients, and 51 (89.5%) patients had a portal pressure gradient below 12 mmHg. Only one (1.8%) major procedure-related complication occurred without any clinical consequences, and no procedure-related deaths occurred. During follow-up, 55 hepatic encephalopathy (HE) episodes occurred in 19 (33.3%) patients, and the median time of the first HE episode was 3.1 months. Seven (12.3%) patients experien...Continue Reading

References

Feb 3, 1998·The American Journal of Gastroenterology·R BañaresE Cos
Jun 25, 2010·The New England Journal of Medicine·Juan Carlos García-PagánUNKNOWN Early TIPS (Transjugular Intrahepatic Portosystemic Shunt) Cooperative Study Group
Mar 25, 2014·Alimentary Pharmacology & Therapeutics·G D'AmicoL Pagliaro
Nov 29, 2015·Journal of Vascular and Interventional Radiology : JVIR·Sean R DariushniaUNKNOWN Society of Interventional Radiology Standards of Practice Committee
Sep 15, 2016·Journal of Gastroenterology and Hepatology·Basile NjeiLoren Laine
Oct 26, 2016·Journal of Clinical Gastroenterology·Brett E FortuneUNKNOWN Vapreotide Study Group
Oct 28, 2016·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Guadalupe Garcia-TsaoJaime Bosch
Feb 9, 2017·Journal of Gastroenterology and Hepatology·Kelsey C LyonMichael Regier
Mar 12, 2018·Disease-a-month : DM·Obada TayyemSheharyar K Merwat

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Citations

Jul 28, 2020·Journal of Gastroenterology and Hepatology·Ahmad KhanShailendra Singh
May 22, 2021·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Aurélie WalterUNKNOWN Salvage TIPS Group

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