Document Detail

Transjugular intrahepatic portosystemic stent-shunt in the management of gastric and ectopic varices.
MedLine Citation:
PMID:  17033434     Owner:  NLM     Status:  MEDLINE    
Uncertainty exists about the ideal therapy for gastric and ectopic varices owing to relatively few controlled studies. Endoscopic therapy with tissue adhesives and thrombin appear promising. Transjugular intrahepatic portosystemic stent-shunt has a role in patients with refractory gastric variceal bleeding in the presence of a patent portal vein. The addition of coil embolization may be particularly useful for ectopic varices, as these can continue to bleed despite successful portal pressure reduction. The high efficacy of transjugular intrahepatic portosystemic stent-shunt has to be balanced against the potential for increased encephalopathy. Balloon occluded retrograde transvenous obliteration is a recent technique for patients with gastro-renal shunts and large gastric varices. Early results are promising, and balloon occluded retrograde transvenous obliteration may be valuable in patients who bleed at lower portal pressures, in the encephalopathic patient, or where the portal vein is not patent. Its use may be limited by availability or lack of technical expertise, and caution is required in patients with large oesophageal varices.
Dhiraj Tripathi; Rajiv Jalan
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  18     ISSN:  0954-691X     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-11     Completed Date:  2007-01-04     Revised Date:  2009-10-16    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1155-60     Citation Subset:  IM    
Department of Hepatology, Royal Infirmary of Edinburgh, Edinburgh, UK.
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MeSH Terms
Balloon Occlusion
Embolization, Therapeutic
Esophageal and Gastric Varices / complications,  surgery*
Gastrointestinal Hemorrhage / etiology,  surgery
Hypertension, Portal / complications,  surgery*
Patient Selection
Portal Vein
Portasystemic Shunt, Transjugular Intrahepatic*
Comment In:
Eur J Gastroenterol Hepatol. 2007 Jul;19(7):612-3   [PMID:  17556913 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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