TIPS--anastomose portossistêmica intra-hepática transjugular. Revisao / TIPS - Transjugular intrahepatic portosystemic shunt. A review
Arq. gastroenterol
;
38(1): 69-80, Jan.-Mar. 2001. tab
Article
Dans Portugais
| LILACS
| ID: lil-290421
RESUMO
At the present time several therapeutic options are used for the treatment of bleeding esophageal varices in patients with portal hypertension. We will review the main medical publications on transjugular intrahepatic portosystemic shunt (TIPS), a procedure seldom used among us. TIPS works as a portocaval side-to-side shunt and decreases the risk of esophageal bleeding through lowering of the portal system pressure and a decrease of the portal hepatic pressure gradient. TIPS consists in the percutaneous insertion, through the internal jugular vein, of a metallic stent under fluoroscopic control in the hepatic parenchyma creating a true porta caval communication. There are several studies demonstrating the efficacy of TIPS, although only a few of them are randomized and control-matched to allow us to conclude that this procedure is safe, efficient and with a good cost benefit ratio. In this review, we search for the analysis of the TIPS utilization, its techniques, its major indications and complications. TIPS has been used in cases of gastroesophageal bleeding that has failed with pharmacologic or endoscopic treatment in patients Child-Pugh B and C. It can be used also as a bridge for liver transplantation. Others indications for TIPS are uncontrolled ascites, hepatic renal syndrome, and hepatic hydrothorax. The main early complications of TIPS using are related to the insertion site and hepatic encephalopathy and the stent occlusion is the chief late complication.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Anastomose portosystémique intrahépatique par voie transjugulaire
/
Hypertension portale
Type d'étude:
Essai clinique contrôlé
/
Etude d'étiologie
Limites du sujet:
Humains
langue:
Portugais
Texte intégral:
Arq. gastroenterol
Thème du journal:
Gastroentérologie
Année:
2001
Type:
Article
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
Universidade Federal do Rio de Janeiro/BR
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