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


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Figure 1

Proportion of patients without recurrent bleedings in the two groups.ET = Endoscopic treatment; TIPS = Transjugular intrahepatic portosystemic shunt
Proportion of patients without recurrent bleedings in the two groups.ET = Endoscopic treatment; TIPS = Transjugular intrahepatic portosystemic shunt

Figure 2

Survival curves for the two groups.Kaplan-Meier curve. ET = Endoscopic treatment; TIPS = transjugular intrahepatic portosystemic shunt; N (TIPS) = 70; N (ET) = 56
Survival curves for the two groups.Kaplan-Meier curve. ET = Endoscopic treatment; TIPS = transjugular intrahepatic portosystemic shunt; N (TIPS) = 70; N (ET) = 56

Predictive factors of recurrent bleeding in the two groups

POR95% CI for OR
valueLowerUpper
Treatment0.000

P < 0.001

7.0883.03916.529
Age > 60 years0.0742.2160.9275.299
Aetiology of liver cirrhosis0.3820.6560.2551.688
Child A0.716
Child B0.6841.2790.3914.190
Child C0.8180.8480.2093.442
Site of bleeding: E0.251
Site of bleeding: G0.0973.0890.81511.712
Site of bleeding: E + G0.8571.1030.3813.190
HE prior to procedure0.7470.9320.6071.430

Cause of death of 86 patients in the two groups

TIPSET
N = 50N = 36
N%N%
Variceal bleeding710.01628.6
Liver failure2231.41221.4
Sepsis11.400.0
Pneumonia34.323.6
Tumor progression68.611.8
Accidental22.900.0
Cardiovascular disease34.335.4
Unknown68.623.6

Baseline demographic, clinical and biochemical characteristics of the 126 patients

TIPSETP
n = 70n = 56value
Sex
        Male45 (64.3%)35 (62.5%)
        Female25 (35.7%)22 (37.5%)0.836
Age53.56 ± 11.1557,57 ± 11,690.052
Etiology
        Alcohol49 (70%)30 (67.9%)
        Non-alcohol21 (30%)18 (32.1%)0.796
Child A15 (21.4%)8 (14.3%)
Child B41 (58.6%)31 (55.4%)
Child C14 (20.0%)17 (30.4%)0.319
Child-Pugh score7.9 ± 1.78.5 ± 1.70.051
Variceal grade
        I–II11 (15.8%)6 (10.7%)
        III–IV59 (84.2%)50 (89.3%)0.519
Type of varices
        Esophageal36 (51.4%)32 (57.1%)
        Gastroesophageal34 (48.6%)24 (42.9%)0.573
Site of bleeding
        Esophagus46 (65.7%)41 (73.2%)
        Gastric7 (10.0%)6 (10.7%)
        Gastroesophageal17 (24.3%)9 (16.1%)0.526
No. of variceal bleeds3.46 ± 1,153.36 ± 1,060.651
Leukocytes (109/L)5.09 ± 1.876.31 ± 3.030.034
Platelets (109/L)109.07 ± 47.82101.96 ± 52.100.309
PT (s)0.64 ± 0.140.57 ± 0.140.003

P < 0.05 vs. control group; bP < 0.001 vs. control group

Bilirubin (mmol/L)40.90 ± 34.9850.91 ± 50.770.125
Albumin (mmol/L)30.78 ± 6.3029.44 ± 5.250.256
Urea (mmol/L)5.81 ± 3.028.33 ± 4.690.001b
Creatinine (mmol/L)78.93 ± 20.46105.91 ± 117.10.226
Ammonia (mmol/L)48.37 ± 23.6660.94 ± 43.790.234
gGT (mkat/L)1.21 ± 1.211.64 ± 1.490.070
ALT (mkat/L)0.51 ± 0.460.74 ± 1.830.409
AST (mkat/L)0.75 ± 0.651.11 ± 2.180.330
Ascites
        No ascites31(44.3%)20 (35.7%)
        Ascites decrease18 (25.7%)13 (25.0%)
        Ascites increase21 (30.0%)22 (39.3%)0.507
HE prior to proc.
        No HE51 (72.9%)39 (69.6%)
        CS, no H17 (24.2%)11 (19.6%)
        CS + H/3 (5.4%)
        CHE2 (2.9%)3 (5.4%)0.295
eISSN:
1581-3207
Język:
Angielski
Częstotliwość wydawania:
4 razy w roku
Dziedziny czasopisma:
Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology, Radiology