Endoscopic Treatment as the Rescue Therapy for Recurrent Bleeding after Transjugular Intrahepatic Portosystemic Shunt (TIPS)
Background. Transjugular intrahepatic portosystemic shunt (TIPS) is suggested as the salvage therapy for gastroesophageal variceal bleeding in cirrhosis. However, rebleeding might occur in some patients after TIPS. Currently, there is a lack of evidence in the endoscopic management of recurrent blee...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2021/6627837 |
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| author | Liyuan Ni Xiaoquan Huang Siyu Jiang Lili Ma Jianjun Luo Shiyao Chen |
| author_facet | Liyuan Ni Xiaoquan Huang Siyu Jiang Lili Ma Jianjun Luo Shiyao Chen |
| author_sort | Liyuan Ni |
| collection | DOAJ |
| description | Background. Transjugular intrahepatic portosystemic shunt (TIPS) is suggested as the salvage therapy for gastroesophageal variceal bleeding in cirrhosis. However, rebleeding might occur in some patients after TIPS. Currently, there is a lack of evidence in the endoscopic management of recurrent bleeding in these patients. Aims. To evaluate the efficacy of endoscopic treatment in cirrhotic patients with recurrent bleeding after TIPS. Methods. Cirrhotic patients with gastroesophageal varices who received endoscopic treatment for recurrent bleeding after TIPS were included. Results. 6 patients were enrolled in this study. The median age of the patients was 47 years (range 27 to 65 years), and the duration of follow-up time was 346 (17-773) days. Stent stenosis or occlusion was found in 5 out of 6 patients after TIPS. Salvage endoscopic treatment, including esophageal variceal ligation (EVL), gastric variceal cyanoacrylate injection, esophageal variceal sclerotherapy, and balloon-occluded retrograde transvenous obliteration- (BRTO-) assisted endoscopic cyanoacrylate injection. Among included patients, 2 died shortly after EVL (14 and 19 days) due to variceal bleeding. Among other 4 patients, 2 had rebleeding episodes at 422 and 789 days, respectively. Conclusion. Endoscopic treatment may be an option for recurrent bleeding after TIPS in selected patients. Further studies are needed to carefully define the indication and efficacy of this option. |
| format | Article |
| id | doaj-art-6d3ec803f6b440b086bfe814427bda85 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
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| series | Gastroenterology Research and Practice |
| spelling | doaj-art-6d3ec803f6b440b086bfe814427bda852025-02-03T07:23:28ZengWileyGastroenterology Research and Practice1687-61211687-630X2021-01-01202110.1155/2021/66278376627837Endoscopic Treatment as the Rescue Therapy for Recurrent Bleeding after Transjugular Intrahepatic Portosystemic Shunt (TIPS)Liyuan Ni0Xiaoquan Huang1Siyu Jiang2Lili Ma3Jianjun Luo4Shiyao Chen5Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, 200032 Shanghai, ChinaDepartment of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, 200032 Shanghai, ChinaDepartment of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, 200032 Shanghai, ChinaEndoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 200032 Shanghai, ChinaDepartment of Interventional Radiology, Zhongshan Hospital, Fudan University, 200032 Shanghai, ChinaDepartment of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, 200032 Shanghai, ChinaBackground. Transjugular intrahepatic portosystemic shunt (TIPS) is suggested as the salvage therapy for gastroesophageal variceal bleeding in cirrhosis. However, rebleeding might occur in some patients after TIPS. Currently, there is a lack of evidence in the endoscopic management of recurrent bleeding in these patients. Aims. To evaluate the efficacy of endoscopic treatment in cirrhotic patients with recurrent bleeding after TIPS. Methods. Cirrhotic patients with gastroesophageal varices who received endoscopic treatment for recurrent bleeding after TIPS were included. Results. 6 patients were enrolled in this study. The median age of the patients was 47 years (range 27 to 65 years), and the duration of follow-up time was 346 (17-773) days. Stent stenosis or occlusion was found in 5 out of 6 patients after TIPS. Salvage endoscopic treatment, including esophageal variceal ligation (EVL), gastric variceal cyanoacrylate injection, esophageal variceal sclerotherapy, and balloon-occluded retrograde transvenous obliteration- (BRTO-) assisted endoscopic cyanoacrylate injection. Among included patients, 2 died shortly after EVL (14 and 19 days) due to variceal bleeding. Among other 4 patients, 2 had rebleeding episodes at 422 and 789 days, respectively. Conclusion. Endoscopic treatment may be an option for recurrent bleeding after TIPS in selected patients. Further studies are needed to carefully define the indication and efficacy of this option.http://dx.doi.org/10.1155/2021/6627837 |
| spellingShingle | Liyuan Ni Xiaoquan Huang Siyu Jiang Lili Ma Jianjun Luo Shiyao Chen Endoscopic Treatment as the Rescue Therapy for Recurrent Bleeding after Transjugular Intrahepatic Portosystemic Shunt (TIPS) Gastroenterology Research and Practice |
| title | Endoscopic Treatment as the Rescue Therapy for Recurrent Bleeding after Transjugular Intrahepatic Portosystemic Shunt (TIPS) |
| title_full | Endoscopic Treatment as the Rescue Therapy for Recurrent Bleeding after Transjugular Intrahepatic Portosystemic Shunt (TIPS) |
| title_fullStr | Endoscopic Treatment as the Rescue Therapy for Recurrent Bleeding after Transjugular Intrahepatic Portosystemic Shunt (TIPS) |
| title_full_unstemmed | Endoscopic Treatment as the Rescue Therapy for Recurrent Bleeding after Transjugular Intrahepatic Portosystemic Shunt (TIPS) |
| title_short | Endoscopic Treatment as the Rescue Therapy for Recurrent Bleeding after Transjugular Intrahepatic Portosystemic Shunt (TIPS) |
| title_sort | endoscopic treatment as the rescue therapy for recurrent bleeding after transjugular intrahepatic portosystemic shunt tips |
| url | http://dx.doi.org/10.1155/2021/6627837 |
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