<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2021-0006_s_005_w2aab3b7c35b1b6b1aab1c16b1Aa"><h3>Background</h3><p>Recurrent bleeding from gastroesophageal varices is the most common life-threatening complication of portal hypertension. According to guidelines, transjugular intrahepatic portosystemic shunt (TIPS) should not be used as a first-line treatment and should be limited to those bleedings which are refractory to pharmacologic and endoscopic treatment (ET). To our knowledge, long-term studies evaluating the role of elective TIPS in comparison to ET in patients with recurrent variceal bleeding episodes are rare.</p></sec><sec id="j_raon-2021-0006_s_006_w2aab3b7c35b1b6b1aab1c16b2Aa"><h3>Patients and methods</h3><p>This study was designed as a retrospective single-institution analysis of 70 patients treated with TIPS and 56 with ET. Patients were followed-up from inclusion in the study until death, liver transplantation, the last follow-up observation or until the end of our study.</p></sec><sec id="j_raon-2021-0006_s_007_w2aab3b7c35b1b6b1aab1c16b3Aa"><h3>Results</h3><p>Recurrent variceal bleeding was significantly more frequent in ET group compared to patients TIPS group (66.1% <italic>vs</italic>. 21.4%, p &lt; 0.001; χ2-test). The incidence of death secondary to recurrent bleeding was higher in the ET group (28.6% <italic>vs</italic>. 10%). Cumulative survival after 1 year, 2 years and 5 years in TIPS group compared to ET group was 85% <italic>vs</italic>. 83%, 73% <italic>vs</italic>. 67% and 41% <italic>vs</italic>. 35%, respectively. The main cause of death in patients with cumulative survival more than 2 years was liver failure. Median observation time was 47 months (range; 2–194 months) in the TIPS group and 40 months (range; 1–168 months) in the ET group.</p></sec><sec id="j_raon-2021-0006_s_008_w2aab3b7c35b1b6b1aab1c16b4Aa"><h3>Conclusions</h3><p>In present study TIPS was more effective in the prevention of recurrent variceal bleeding and had lower mortality due to recurrent variceal bleeding compared to ET.</p></sec></abstract>

BackgroundRecurrent bleeding from gastroesophageal varices is the most common life-threatening complication of portal hypertension. According to guidelines, transjugular intrahepatic portosystemic shunt (TIPS) should not be used as a first-line treatment and should be limited to those bleedings which are refractory to pharmacologic and endoscopic treatment (ET). To our knowledge, long-term studies evaluating the role of elective TIPS in comparison to ET in patients with recurrent variceal bleeding episodes are rare.Patients and methodsThis study was designed as a retrospective single-institution analysis of 70 patients treated with TIPS and 56 with ET. Patients were followed-up from inclusion in the study until death, liver transplantation, the last follow-up observation or until the end of our study.ResultsRecurrent variceal bleeding was significantly more frequent in ET group compared to patients TIPS group (66.1% vs. 21.4%, p < 0.001; χ2-test). The incidence of death secondary to recurrent bleeding was higher in the ET group (28.6% vs. 10%). Cumulative survival after 1 year, 2 years and 5 years in TIPS group compared to ET group was 85% vs. 83%, 73% vs. 67% and 41% vs. 35%, respectively. The main cause of death in patients with cumulative survival more than 2 years was liver failure. Median observation time was 47 months (range; 2–194 months) in the TIPS group and 40 months (range; 1–168 months) in the ET group.ConclusionsIn present study TIPS was more effective in the prevention of recurrent variceal bleeding and had lower mortality due to recurrent variceal bleeding compared to ET.

TIPS <italic>vs</italic>. endoscopic treatment for prevention of recurrent variceal bleeding: a long-term follow-up of 126 patients

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

TIPS . endoscopic treatment for prevention of recurrent variceal bleeding: a long-term follow-up of 126 patients

BackgroundRecurrent bleeding from gastroesophageal varices is the most common life-threatening complication of portal hypertension. According to guidelines,...

TIPS vs. endoscopic treatment for prevention of recurrent variceal bleeding: a long-term follow-up of 126 patients

Article Category: Research Article

Publié en ligne: 26 janv. 2021

Pages: 164 - 171

Reçu: 10 déc. 2020

Accepté: 07 janv. 2021

DOI: https://doi.org/10.2478/raon-2021-0006

© 2021 Spela Korsic, Borut Stabuc, Pavel Skok, Peter Popovic, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.