Prevention of rebleeding from oesophageal-gastric varices.

Abstract:

:Endoscopic sclerotherapy or ligation and/or drugs are the standard treatments for the prevention of variceal rebleeding. Failure of this treatment indicates the need for rescue transjugular intrahepatic portosystemic shunt (TIPS) implantation. The current practice to use endoscopic treatment as first-line and TIPS as second-line treatment is, however, not based on evidence since, in unselected patients, both treatments have a comparable survival. In addition, the timing for a change from endoscopic treatment to TIPS is not exactly defined. According to the randomized studies available a change may be recommended when uncontrolled rebleeding or more than two rebleedings within a time interval of 6-12 months indicate failure of the endoscopic treatment. This regimen may be reconsidered when future developments improve outcome of one or the other treatment. In this regard the TIPS treatment has a potential of improvement if further reduction of the rate of rebleeding can be achieved with less stenosis, and/or reduced encephalopathy.

authors

Rössle M

doi

10.1097/00042737-200104000-00007

subject

Has Abstract

pub_date

2001-04-01 00:00:00

pages

343-8

issue

4

eissn

0954-691X

issn

1473-5687

journal_volume

13

pub_type

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