Abstract:
BACKGROUND:Transjugular intrahepatic portosystemic stent-shunts (TIPSS) are becoming widely used in the management of oesophageal variceal haemorrhage (OVH). Their place in the treatment of gastric variceal haemorrhage (GVH), a condition with a traditionally poor prognosis, remains unclear. The aims of our study were to compare portal haemodynamics and patient outcome in patients undergoing TIPSS for either GVH or OVH. PATIENTS AND METHODS:106 consecutive patients undergoing TIPSS at our institution for either GVH (32 patients) or OVH (74 patients) were studied. The groups were similar with regard to patient age, aetiology and severity of liver disease and number of procedures carried out as an emergency (34.4% vs. 36.5%). Episodes of shunt insufficiency, rebleeding, encephalopathy and other clinical sequela were recorded. Mean follow-up was similar in both patient groups (14.2 vs. 12.1 months). RESULTS:Baseline portocaval pressure gradient was lower in patients with GVH compared with those with OVH (13.0+/-0.9 mmHg vs. 19.0+/-0.6 mmHg) (P < 0.001). Rates of variceal rebleeding, encephalopathy and shunt insufficiency during follow-up were similar in both groups and there was no difference in survival. CONCLUSION:Patients with GVH had markedly lower portocaval pressure gradients than those with OVH, but shunt and clinical complications and survival were similar during follow-up. TIPSS appears to be an effective treatment for GVH and should be compared with endoscopic or surgical techniques in controlled trials.
journal_name
Aliment Pharmacol Therjournal_title
Alimentary pharmacology & therapeuticsauthors
Stanley AJ,Jalan R,Ireland HM,Redhead DN,Bouchier IA,Hayes PCdoi
10.1046/j.1365-2036.1997.106277000.xsubject
Has Abstractpub_date
1997-02-01 00:00:00pages
171-6issue
1eissn
0269-2813issn
1365-2036journal_volume
11pub_type
临床试验,杂志文章abstract:BACKGROUND:Gastrointestinal (GI) symptoms are common in soldiers in combat or high-pressure operational situations and often lead to compromised performance. Underlying mechanisms are unclear, but neuroendocrine dysregulation, immune activation and increased intestinal permeability may be involved in stress-related GI ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.12269
更新日期:2013-04-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2036.1999.00512.x
更新日期:1999-07-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2014-01-01 00:00:00
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doi:10.1111/apt.12381
更新日期:2013-08-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2011-03-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,多中心研究
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doi:10.1111/apt.13939
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章
doi:10.1046/j.1365-2036.1997.00209.x
更新日期:1997-08-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1365-2036.2008.03814.x
更新日期:2008-11-01 00:00:00
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pub_type: 杂志文章,meta分析
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更新日期:2000-02-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1046/j.1365-2036.1997.00230.x
更新日期:1997-10-01 00:00:00
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journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
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更新日期:1996-02-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1995-10-01 00:00:00
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更新日期:2004-11-15 00:00:00
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更新日期:2015-01-01 00:00:00
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更新日期:2013-12-01 00:00:00
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更新日期:2012-09-01 00:00:00
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更新日期:2019-10-01 00:00:00