Abstract:
BACKGROUND AND OBJECTIVE:Currently, monitoring hepatic venous pressure gradient (HVPG) have been proved to be the best predictor for the risk of variceal bleeding. We performed the study to evaluate the effect of endoscopic therapy + β-blocker vs. covered transjugular intrahepatic portosystemic shunt (TIPS) for the prevention of variceal rebleeding in cirrhotic patients with HVPG ≥16 mmHg. METHODS:Consecutive cirrhotic patients with HVPG ≥16 mmHg treated with endoscopic therapy + β-blocker or covered TIPS for variceal bleeding were retrospectively gathered between April 2013 and December 2018. The variceal rebleeding rate, survival, and incidence of overt hepatic encephalopathy (OHE) were compared. RESULTS:A total of 83 patients were analyzed, of which 46 received endoscopic therapy + β-blocker and 37 covered TIPS. During a median follow-up of 12.0 months, the rebleeding rate (32.6 vs. 10.8%, P = 0.017) and rate of OHE (2.2 vs. 27.0%, P = 0.001) showed significant differences between the two groups, while liver transplantation-free survival (93.5 vs. 94.6%, P = 0.801) was similar. Preoperative and postoperative Child-Turcotte-Pugh scores were similar in either group. In addition, no significant differences of rebleeding rate (25.0 vs. 21.3%, P = 0.484) and survival (97.2 vs. 91.5%, P = 0.282) were observed between patients with 16 mmHg ≤ HVPG < 20 mmHg and HVPG ≥ 20 mmHg. CONCLUSION:Covered TIPS was more effective than endoscopic therapy + β-blocker in preventing rebleeding in patients with HVPG ≥16 mmHg but did not improve survival. TIPS also induce more OHE.
journal_name
Eur J Gastroenterol Hepatoljournal_title
European journal of gastroenterology & hepatologyauthors
Guo H,Zhang F,Yin X,Zhang M,Xiao J,Wang Y,Zhang B,Zhang W,Zou X,Zhuge Ydoi
10.1097/MEG.0000000000001872subject
Has Abstractpub_date
2020-08-28 00:00:00eissn
0954-691Xissn
1473-5687pub_type
杂志文章abstract:OBJECTIVE:We sought a good indicator cell line to use in detecting the vacuolating toxin produced by Helicobacter pylori and in examining the characteristics of the toxin. DESIGN AND METHODS:Using five cell lines [baby hamster kidney (BHK-21), human amnion (FL), human uterine cancer (HeLa), rabbit kidney (RK-13) and A...
journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:The accuracy of diagnostic tests to assess Helicobacter pylori eradication has rarely been performed. AIM:To compare the tests most commonly used for this purpose, i.e. histology, culture and (13)C urea breath test performed in centralized facilities. METHODS:Prospective study where patients were included ...
journal_title:European journal of gastroenterology & hepatology
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journal_title:European journal of gastroenterology & hepatology
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journal_title:European journal of gastroenterology & hepatology
pub_type: 杂志文章
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journal_title:European journal of gastroenterology & hepatology
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doi:
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journal_title:European journal of gastroenterology & hepatology
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journal_title:European journal of gastroenterology & hepatology
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:European journal of gastroenterology & hepatology
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pub_type: 评论,杂志文章
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pub_type: 杂志文章,随机对照试验
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更新日期:2016-01-01 00:00:00
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journal_title:European journal of gastroenterology & hepatology
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更新日期:2021-01-01 00:00:00