Drugs combined with endoscopic therapy versus transjugular intrahepatic portosystemic shunt in management of esophageal and gastric variceal bleeding / 中国内镜杂志

ABSTRACT

Objective To compare the short term and long term efficacy of drugs combined with endoscopic therapy (ET) and transjugular intrahepatic portosystemic shunt (TIPS) in treatment of esophageal and gastric variceal bleeding (EGVB) in cirrhotic patients. Methods We reviewed 120 cases of patients admitted for acute esophageal and gastric variceal bleeding from January 2010 to December 2014, treated with drugs combined with endoscopy (n = 77) or TIPS (n = 43). The incidence of failure to control bleeding, long term rebleeding, mortality and complications were compared. Results Patients treated with TIPS had a higher probability of remaining free of bleeding or rebleeding than patients receving drugs+ET (59.7％ vs. 81.4％, P < 0.05). The incidence of hepatic encephalopathy in the drugs + ET group was lower than that in the TIPS group (13.2％ vs 27.9％, P < 0.05). There was no significant difference in the control of acute bleeding (96.1％ vs 97.7％, P > 0.05) and mortality (10.4％ vs. 4.7％, P > 0.05) between the two groups. Conclusions Both drugs+ET and TIPS surgery can control EGVB well, TIPS can better prevent the occurrence of rebleeding but will lead to a higher incidence of hepatic encephalopathy.