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Two-year outcome following transjugular intrahepatic portosystemic shunt for variceal bleeding: results in 90 patients.
LaBerge, J M; Somberg, K A; Lake, J R; Gordon, R L; Kerlan, R K; Ascher, N L; Roberts, J P; Simor, M M; Doherty, C A; Hahn, J.
Afiliación
  • LaBerge JM; Department of Radiology, University of California, San Francisco.
Gastroenterology ; 108(4): 1143-51, 1995 Apr.
Article en En | MEDLINE | ID: mdl-7698582
BACKGROUND/AIMS: Transjugular intrahepatic portosystemic shunt (TIPS) is a new therapy for variceal bleeding. Immediate technical and short-term clinical results have been reported. This study was undertaken to evaluate mid-term outcome after TIPS in patients who successfully underwent the procedure for variceal bleeding. METHODS: Ninety patients were followed up prospectively by clinical examination and radiological shunt evaluation including Doppler sonography and transjugular portal venography. RESULTS: The average follow-up in surviving patients was 2.2 years. The cumulative survival rate was 60% at 1 year and 51% at 2 years. The rate of cumulative rebleeding was 26% at 1 year and 32% at 2 years. A shunt abnormality was noted in all rebleeding patients. Rebleeding was successfully controlled in all but 1 of the patients who underwent shunt revision. Cumulative detection of stenosis or occlusion was 31% at 1 year and 47% at 2 years. Thirty-eight percent of shunt abnormalities were detected by routine surveillance. Percutaneous shunt revision was attempted in 22 patients and was successful in 21 (95%). CONCLUSIONS: Although mid-term primary patency is limited in many patients by the development of a shunt stenosis or occlusion, shunt function can be maintained in most patients by careful surveillance and periodic percutaneous intervention.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derivación Portosistémica Quirúrgica / Várices Esofágicas y Gástricas / Hemorragia Gastrointestinal Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Child / Child, preschool / Female / Humans / Male / Middle aged Idioma: En Revista: Gastroenterology Año: 1995 Tipo del documento: Article Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derivación Portosistémica Quirúrgica / Várices Esofágicas y Gástricas / Hemorragia Gastrointestinal Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Child / Child, preschool / Female / Humans / Male / Middle aged Idioma: En Revista: Gastroenterology Año: 1995 Tipo del documento: Article Pais de publicación: Estados Unidos