Transjugular intrahepatic portosystemic shunt for patients with cirrhosis and acute variceal bleeding:rescue or first-line therapy?

Han GuoHong; Qi XingShun; Fan DaiMing

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Mar. 2011

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Article Navigation > Journal of Clinical Hepatology > 2011 > 27(3): 239-240+247

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Transjugular intrahepatic portosystemic shunt for patients with cirrhosis and acute variceal bleeding:rescue or first-line therapy?

Published Date: 2011-03-20

Abstract

Abstract

In the current American Association for the Study of Liver Disease Practice Guidelines, the use of transjugular intrahepatic portosystemic shunt (TIPS) to control variceal bleeding has largely been recommended for patients who require rescue therapy because hemostasis has not been achieved.TIPS is extremely effective in controlling bleeding, nevertheless, mortality at 6 weeks among patients treated with rescue TIPS for uncontrolled index bleeding is very high.Recently, the results of a multi-center randomized controlled study that compared early TIPS with optimal medical therapy in patients at high risk for rebleeding who were either in Child-Pugh class B with active bleeding at endoscopy or in Child-Pugh class C showed the benefit of early TIPS.Therefore, the early use of TIPS with an e-PTFE-covered stent as first-line therapy rather than as rescue treatment if rebleeding occurs in high-risk patients with Child-Pugh B or C disease.
- portosystemic shunt,
- transjugular intrahepatic,
- esophageal and gastric varices,
- gastrointestinal hemorrhage,
- hypertension

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References

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通讯作者: 陈斌, bchen63@163.com

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沈阳化工大学材料科学与工程学院沈阳 110142

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Transjugular intrahepatic portosystemic shunt for patients with cirrhosis and acute variceal bleeding:rescue or first-line therapy?

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Transjugular intrahepatic portosystemic shunt for patients with cirrhosis and acute variceal bleeding:rescue or first-line therapy?

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