| Alcoholic versus nonalcoholic cirrhosis in a randomized controlled trial of emergency therapy of bleeding varices. | |
| | |
MedLine Citation:
|
PMID: 21195430 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: It has been proposed that portal-systemic shunts be avoided in alcoholic cirrhotics because survival rate is allegedly lower in alcoholics than in nonalcoholics. We examined this issue in a randomized controlled trial. METHODS: Two hundred eleven unselected, consecutive patients with cirrhosis and bleeding esophageal varices were randomized to endoscopic sclerotherapy (EST) (n = 106) or emergency portacaval shunt (EPCS) (105). Treatment was initiated within 8 h. EST failure was treated by rescue portacaval shunt (PCS). Ten-year follow-up was 96%. RESULTS: Results strongly favored EPCS over EST (P < 0.001). Among EPCS patients, 83% were alcoholic and 17% nonalcoholic. Outcomes were (1) permanent control of bleeding 100% versus 100%; (2) 5-y survival 71% versus 78%; (3) encephalopathy 14% versus 19%; (4) yearly charges $38,300 versus $43,000. CONCLUSIONS: EPCS results were similar in alcoholic and nonalcoholic cirrhotics. EPCS is an effective first line emergency treatment in all forms of cirrhosis, including alcoholic. |
| | |
Authors:
|
Marshall J Orloff; Jon I Isenberg; Henry O Wheeler; Kevin S Haynes; Horacio Jinich-Brook; Roderick Rapier; Florin Vaida; Robert J Hye; Susan L Orloff |
Publication Detail:
|
Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2010-12-03 |
Journal Detail:
|
Title: The Journal of surgical research Volume: 174 ISSN: 1095-8673 ISO Abbreviation: J. Surg. Res. Publication Date: 2012 May |
Date Detail:
|
Created Date: 2012-03-28 Completed Date: 2012-05-14 Revised Date: 2013-05-03 |
Medline Journal Info:
|
Nlm Unique ID: 0376340 Medline TA: J Surg Res Country: United States |
Other Details:
|
Languages: eng Pagination: 98-105 Citation Subset: IM |
Copyright Information:
|
Copyright © 2012 Elsevier Inc. All rights reserved. |
Affiliation:
|
Department of Surgery, University of California, San Diego Medical Center, 200West Arbor Drive, San Diego, CA 92103-8999, USA. morloff@ucsd.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Emergency Treatment*
/
economics Endoscopy Esophageal and Gastric Varices / mortality, therapy* Gastrointestinal Hemorrhage / mortality, therapy* Health Care Costs Humans Liver Cirrhosis / complications* Liver Cirrhosis, Alcoholic / complications* Portasystemic Shunt, Transjugular Intrahepatic Sclerotherapy |
| Grant Support | |
ID/Acronym/Agency:
|
1R01DK41920/DK/NIDDK NIH HHS; R01 DK041920-07/DK/NIDDK NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Intrahepatic Radiofrequency Ablation Versus Electrochemical Treatment Ex Vivo.
Next Document: A Prospective Case-Control Study of the Local and Systemic Cytokine Response After Laparoscopic Vers...