Zhonghua yi xue za zhi · 2012
[Transjugular intrahepatic portosystemic shunt plus embolotherapy in the treatment of gastroesophageal varices: a report of 38 patients].
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Wang Hong-bo, Zhang An-zhong, Yang Chong-mei, Cui Yi, Zhang Jun-yong, Liu Fu-li, Zhang Chun-qing
Аннотация
OBJECTIVE: To evaluate the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) plus embolotherapy in the treatment of patients with gastroesophageal varices.
METHODS: A total of 36 patients with gastroesophageal varices underwent the therapies of TIPS plus embolotherapy from July 2005 to March 2011 at Provincial Hospital Affiliated to Shandong University. The rechecked items included abdominal ultrasound examination, liver function test and blood routine examination at Day 7 post-operation. All received endoscopic examinations at Month 1.
RESULTS: The technical success rate of TIPS plus embolotherapy was 100%. The portal vein pressures declined from (28 ± 8) mm Hg (1 mm Hg = 0.133 kPa) to (14 ± 7) mm Hg at post-operation. Angiography showed gastroesophageal varices disappeared in all patients. Both liver function and gastroesophageal varices markedly improved. During the follow-up period of 3 - 6 months, 4 cases had hepatic encephalopathy and 1 case stent restenosis at post-operation. And most cases were resolved after treatment. No rebleeding occurred during the follow-up period.
CONCLUSIONS: The combined modality of TIPS plus embolotherapy can effectively lower portal vein pressure and cure esophageal and gastric varice bleeding. As a safe and excellent interventional procedure with fewer complications and a lower recurrence rate of portal hypertension, it has great clinical values in the treatment of portal hypertension and gastroesophageal varices.
METHODS: A total of 36 patients with gastroesophageal varices underwent the therapies of TIPS plus embolotherapy from July 2005 to March 2011 at Provincial Hospital Affiliated to Shandong University. The rechecked items included abdominal ultrasound examination, liver function test and blood routine examination at Day 7 post-operation. All received endoscopic examinations at Month 1.
RESULTS: The technical success rate of TIPS plus embolotherapy was 100%. The portal vein pressures declined from (28 ± 8) mm Hg (1 mm Hg = 0.133 kPa) to (14 ± 7) mm Hg at post-operation. Angiography showed gastroesophageal varices disappeared in all patients. Both liver function and gastroesophageal varices markedly improved. During the follow-up period of 3 - 6 months, 4 cases had hepatic encephalopathy and 1 case stent restenosis at post-operation. And most cases were resolved after treatment. No rebleeding occurred during the follow-up period.
CONCLUSIONS: The combined modality of TIPS plus embolotherapy can effectively lower portal vein pressure and cure esophageal and gastric varice bleeding. As a safe and excellent interventional procedure with fewer complications and a lower recurrence rate of portal hypertension, it has great clinical values in the treatment of portal hypertension and gastroesophageal varices.