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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 7
Jul.  2014
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Article Contents

Role of transjugular intrahepatic portosystemic shunt in prevention and treatment of variceal bleeding in liver cirrhosis

DOI: 10.3969/j.issn.1001-5256.2014.07.031
  • Received Date: 2014-02-24
  • Published Date: 2014-07-20
  • In patients with liver cirrhosis, variceal bleeding is a common fatal complication of portal hypertension. Varices are present in almost half of patients with cirrhosis at the time of diagnosis. Since transjugular intrahepatic portosystemic shunt (TIPS) was first applied clinically in 1988, the relevant information about TIPS has been continually updated and perfected by lots of clinical trials. The role of TIPS in the prevention and treatment of variceal bleeding in cirrhotic patients with portal hypertension, including primary prevention of variceal bleeding, treatment of acute variceal bleeding, and prevention of rebleeding, is reviewed. TIPS is an effective treatment for variceal bleeding in cirrhotic patients with portal hypertension. Along with the technical development, TIPS will be available for more and more patients and will play an increasingly important role in the prevention and treatment of variceal bleeding among cirrhotic patients with portal hypertension.

     

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  • [1] GARCIA-TSAO G, BOSCH J.Management of varices and variceal hemorrhage in cirrhosis[J].N Engl J Med, 2010, 362 (9) :823-832.
    [2]D'AMICO G, PAGLIARO L, BOSCH J.The treatment of portal hypertension:a meta-analytic review[J].Hepatology, 1995, 22 (1) :332-354.
    [3]BOYER TD, HASKAL ZJ.The role of transjugular intrahepatic portosystemic shunt (TIPS) in the management of portal hypertension:update 2009[J].Hepatology, 2010, 51 (1) :306.
    [4]WU ZG, ZHOU RM.Clinical follow-up results of patients after transjugular intrahepatic portosystemic shunt[J].J Clin Hepatol, 1999, 15 (2) :118-120. (in Chinese) 吴子刚, 周若美.经颈静脉肝内门体分流术后的临床随访结果[J].临床肝胆病杂志, 1999, 15 (2) :118-120.
    [5]NI JB, ZHANG JW, LI ZL, et al.Short-term efficacy of transjugular intrahepatic portosystemic shunt combined with tissue adhesive embolization in prevention and treatment of esophageal and gastric varices bleeding[J].Chin J Dig, 2010, 30 (11) :842-844. (in Chinese) 倪景斌, 张建武, 李振磊, 等.经颈静脉肝内门体分流术联合组织胶栓塞治疗和预防食管胃底静脉出血近期疗效的研究[J].中华消化杂志, 2010, 30 (11) :842-844.
    [6]GARCIA-TSAO G, SANYAL AJ, GRACE ND, et al.Prevention and management of gastroesophageal varices and variceal hemorrhage in cirrhosis[J].Hepatology, 2007, 46 (3) :922-938.
    [7]BOSCH J, ABRALDES JG, BERZIGOTTI A, et al.Portal hyper-tension and gastrointestinal bleeding[J].Semin Liver Dis, 2008, 28 (1) :3-25.
    [8]BOSCH J.Salvage transjugular intrahepatic portosystemic shunt:is it really life-saving?[J].J Hepatol, 2001, 35 (5) :658-660.
    [9]ESCORSELL A, BANARES R, GARCIA-PAGAN JC, et al.TIPS versus drug therapy in preventing variceal rebleeding in advanced cirrhosis:a randomized controlled trial[J].Hepatology, 2002, 35 (2) :385-392.
    [10]MONESCILLO A, MARTINEZ-LAGARES F, RUIZ-DEL-ARBOL L, et al.Influence of portal hypertension and its early decompression by TIPS placement on the outcome of variceal bleeding[J].Hepatology, 2004, 40 (4) :793-801.
    [11] GARCIA-PAGAN JC, CACA K, BUREAU C, et al.Early use of TIPS in patients with cirrhosis and variceal bleeding[J].N Engl J Med, 2010, 362 (25) :2370-2379.
    [12]GARCIA-PAGAN JC, DI PASCOLI M, CACA K, et al.Use of early-TIPS for high-risk variceal bleeding:results of a postRCT surveillance study[J].J Hepatol, 2013, 58 (1) :45-50.
    [13] AUGUSTIN S, ALTAMIRANO J, GONZALEZ A, et al.Effectiveness of combined pharmacologic and ligation therapy in high-risk patients with acute esophageal variceal bleeding[J].Am J Gastroenterol, 2011, 106 (10) :1787-1795.
    [14]REVERTER E, TANDON P, AUGUSTIN S, et al.A MELDbased model to determine risk of mortality among patients with acute variceal bleeding[J].Gastroenterology, 2014, 146 (2) :412-419.
    [15]CHAU TN, PATCH D, CHAN YW, et al.“Salvage”transjugular intrahepatic portosystemic shunts:gastric fundal compared with esophageal variceal bleeding[J].Gastroenterology, 1998, 114 (5) :981-987.
    [16]BARANGE K, PERON JM, IMANI K, et al.Transjugular intrahepatic portosystemic shunt in the treatment of refractory bleeding from ruptured gastric varices[J].Hepatology, 1999, 30 (5) :1139-1143.
    [17]QI XS, HAN GH, FAN DM.Recent advances in the clinical application of transjugular intrahepatic portosystemic shunt for the treatment of portal hypertension[J].J Intervent Radiol, 2011, 20 (6) :499-504. (in Chinese) 祁兴顺, 韩国宏, 樊代明.经颈内静脉肝内门体分流术临床应用新进展[J].介入放射学杂志, 2011, 20 (6) :499-504.
    [18]SHARARA AI, ROCKEY DC.Gastroesophageal variceal hemorrhage[J].N Engl J Med, 2001, 345 (9) :669-681.
    [19]GONZALEZ R, ZAMORA J, GOMEZ-CAMARERO J, et al.Meta-analysis:Combination endoscopic and drug therapy to prevent variceal rebleeding in cirrhosis[J].Ann Intern Med, 2008, 149 (2) :109-122.
    [20]BURROUGHS AK, VANGELI M.Transjugular intrahepatic portosystemic shunt versus endoscopic therapy:randomized trials for secondary prophylaxis of variceal bleeding:an updated meta-analysis[J].Scand J Gastroenterol, 2002, 37 (3) :249-252.
    [21]ZHENG M, CHEN Y, BAI J, et al.Transjugular intrahepatic portosystemic shunt versus endoscopic therapy in the secondary prophylaxis of variceal rebleeding in cirrhotic patients:meta-analysis update[J].J Clin Gastroenterol, 2008, 42 (5) :507-516.
    [22]LO GH, LIANG HL, CHEN WC, et al.A prospective, randomized controlled trial of transjugular intrahepatic portosystemic shunt ver-sus cyanoacrylate injection in the prevention of gastric variceal rebleeding[J].Endoscopy, 2007, 39 (8) :679-685.
    [23]ROSEMURGY AS, BLOOMSTON M, CLARK WC, et al.H-graft portacaval shunts versus TIPS:ten-year follow-up of a randomized trial with comparison to predicted survivals[J].Ann Surg, 2005, 241 (2) :238-246.
    [24]HENDERSON JM, BOYER TD, KUTNER MH, et al.Distal splenorenal shunt versus transjugular intrahepatic portal systematic shunt for variceal bleeding:a randomized trial[J].Gastroenterology, 2006, 130 (6) :1643-1651.
    [25]D'AMICO G, LUCA A.TIPS is a cost effective alternative to surgical shunt as a rescue therapy for prevention of recurrent bleeding from esophageal varices[J].J Hepatol, 2008, 48 (3) :387-390.
    [26]LIANG YP, TANG YM, YANG JH, et al.Transjugular intrahepatic portosystemic shunt dysfunction[J].World Chin J Dig, 2013, 21 (4) :336-340. (in Chinese) 梁艳平, 唐映梅, 杨晋辉, 等.TIPS术后支架功能障碍的研究现状[J].世界华人消化杂志, 2013, 21 (4) :336-340.
    [27]PERARNAU JM, LE GOUGE A, NICOLAS C, et al.Covered vs.uncovered stents for transjugular intrahepatic portosystemic shunt:A randomized controlled trial[J].J Hepatol, 2014, 60 (5) :962-968
    [28]LIND CD, MALISCH TW, CHONG WK, et al.Incidence of shunt occlusion or stenosis following transjugular intrahepatic portosystemic shunt placement[J].Gastroenterology, 1994, 106 (5) :1277-1283.
    [29]CAI W, ZHUGE YZ, QIU YD, et al.Risk factors and countermeasures of shunt dysfunction and hepatic encephalopathy after transjugular intrahepatic portosystemic shunt[J].Chin J Dig Surg, 2013, 12 (11) :850-854. (in Chinese) 蔡炜, 诸葛宇征, 仇毓东, 等.经颈静脉肝内门体分流术后分流道失功和肝性脑病发生的危险因素及预防对策[J].中华消化外科杂志, 2013, 12 (11) :850-854.
    [30]BAI M, QI X, YANG Z, et al.Predictors of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in cirrhotic patients:a systematic review[J].J Gastroenterol Hepatol, 2011, 26 (6) :943-951.
    [31]MALEUX G, HEYE S, VERSLYPE C, et al.Management of transjugular intrahepatic portosystemic shunt induced refractory hepatic encephalopathy with the parallel technique:results of a clinical follow-up study[J].J Vasc Interv Radiol, 2007, 18 (8) :986-992, 993.
    [32]FORAUER AR, MCLEAN GK.Transjugular intrahepatic portosystemic shunt constraining stent for the treatment of refractory postprocedural encephalopathy:a simple design utilizing a Palmaz stent and Wallstent[J].J Vasc Interv Radiol, 1998, 9 (3) :443-446.
    [33]HAN GH, QI XS, FAN DM.Transjugular intrahepatic portosystemic shunt for patients with cirrhosis and acute variceal bleeding:rescue or first-line therapy?[J].J Clin Hepatol, 2011, 27 (3) :239-240. (in Chinese) 韩国宏, 祁兴顺, 樊代明.TIPS治疗肝硬化门脉高压急性静脉曲张出血:救命治疗还是一线治疗?[J].临床肝胆病杂志, 2011, 27 (3) :239-240.
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