Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt in Patients with Recurrent Variceal Hemorrhage
Purpose. The purpose of this study was to determine the incidence and predictors of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) and endoscopic therapy (ET) in the elective treatment of recurrent variceal hemorrhage. Methods. Seventy patients were treated wi...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2013/398172 |
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| author | Popovič Peter Zore Andrej Šurlan Popovič Katarina Garbajs Manca Skok Pavel |
| author_facet | Popovič Peter Zore Andrej Šurlan Popovič Katarina Garbajs Manca Skok Pavel |
| author_sort | Popovič Peter |
| collection | DOAJ |
| description | Purpose. The purpose of this study was to determine the incidence and predictors of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) and endoscopic therapy (ET) in the elective treatment of recurrent variceal hemorrhage. Methods. Seventy patients were treated with elective TIPS and fifty-six patients with ET. Median observation time was 46.28 months in the TIPS group and 42.31 months in the ET group. Results. 30 patients (42.8%) developed clinically evident portosystemic encephalopathy in TIPS group and 20 patients (35.6%) in ET group. The difference between the groups was not statistically significant (P=0.542; χ2 test). The incidence of new or worsening portosystemic encephalopathy was 24.3% in TIPS group and 10.7% in ET group. Multivariate analysis showed that ET treatment (P=0.031), age of >65 years (P=0.022), pre-existing HE (P=0.045), and Child's class C (P=0.051) values were independent predictors for the occurrence of HE. Conclusions. Procedure-related HE is a complication in a minority of patients treated with TIPS or ET. Patients with increased age, preexisting HE, and higher Child-Pugh score should be carefully observed after TIPS procedure because the risk of post-TIPS HE in these patients is higher. |
| format | Article |
| id | doaj-art-f6988d1b3ac647ba86991996b40a9ea3 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-f6988d1b3ac647ba86991996b40a9ea32025-02-03T05:43:55ZengWileyGastroenterology Research and Practice1687-61211687-630X2013-01-01201310.1155/2013/398172398172Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt in Patients with Recurrent Variceal HemorrhagePopovič Peter0Zore Andrej1Šurlan Popovič Katarina2Garbajs Manca3Skok Pavel4Institute of Radiology, University Medical Centre Ljubljana, Zaloška cesta 7, 1525 Ljubljana, SloveniaDepartment of Ginecology, University Medical Centre Ljubljana, Zaloška cesta 7, 1525 Ljubljana, SloveniaInstitute of Radiology, University Medical Centre Ljubljana, Zaloška cesta 7, 1525 Ljubljana, SloveniaInstitute of Radiology, University Medical Centre Ljubljana, Zaloška cesta 7, 1525 Ljubljana, SloveniaDepartment of Gastroenterology and Endoscopy, University Medical Centre Maribor, University of Maribor, Ljubljanska Ulica 5, 2000 Maribor and Medical Faculty, Slomškov trg 15, 2000 Maribor, SloveniaPurpose. The purpose of this study was to determine the incidence and predictors of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) and endoscopic therapy (ET) in the elective treatment of recurrent variceal hemorrhage. Methods. Seventy patients were treated with elective TIPS and fifty-six patients with ET. Median observation time was 46.28 months in the TIPS group and 42.31 months in the ET group. Results. 30 patients (42.8%) developed clinically evident portosystemic encephalopathy in TIPS group and 20 patients (35.6%) in ET group. The difference between the groups was not statistically significant (P=0.542; χ2 test). The incidence of new or worsening portosystemic encephalopathy was 24.3% in TIPS group and 10.7% in ET group. Multivariate analysis showed that ET treatment (P=0.031), age of >65 years (P=0.022), pre-existing HE (P=0.045), and Child's class C (P=0.051) values were independent predictors for the occurrence of HE. Conclusions. Procedure-related HE is a complication in a minority of patients treated with TIPS or ET. Patients with increased age, preexisting HE, and higher Child-Pugh score should be carefully observed after TIPS procedure because the risk of post-TIPS HE in these patients is higher.http://dx.doi.org/10.1155/2013/398172 |
| spellingShingle | Popovič Peter Zore Andrej Šurlan Popovič Katarina Garbajs Manca Skok Pavel Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt in Patients with Recurrent Variceal Hemorrhage Gastroenterology Research and Practice |
| title | Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt in Patients with Recurrent Variceal Hemorrhage |
| title_full | Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt in Patients with Recurrent Variceal Hemorrhage |
| title_fullStr | Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt in Patients with Recurrent Variceal Hemorrhage |
| title_full_unstemmed | Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt in Patients with Recurrent Variceal Hemorrhage |
| title_short | Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt in Patients with Recurrent Variceal Hemorrhage |
| title_sort | hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in patients with recurrent variceal hemorrhage |
| url | http://dx.doi.org/10.1155/2013/398172 |
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