[Prevention of variceal rebleeding by TIPS combined with embolization of gastric coronary veins: a clinical controlled study].

ABSTRACT

OBJECTIVE: To prospectively compare the rates of gastroesophageal variceal rebleeding in patients underwent TIPS alone and TIPS combined with embolization of gastric coronary veins. METHODS: According to the bleeding state within one week before the shunt placement, 122 patients with hepatic cirrhosis indicated for the secondary prevention of gastroesophageal variceal rebleeding were allocated to the shunt group (n = 44, treated with TIPS alone) and the shunt plus embolization group (n = 78, treated with TIPS combined with embolization of gastric coronary veins). All the patients were followed up for 1 year, and the 1-year cumulative rates of rebleeding, shunt patency and mortality were compared. RESULTS: The basic characteristics of patients in the two groups were comparable (P is more than 0.05). The 1-year cumulative re-bleeding rates were 41.5% in the shunt group and 19.5% in the shunt combined with embolization group (x2 = 6.320, P = 0.012). The differences of 1-year cumulative rates of shunt patency and mortality between the two groups were not significant (P is more than 0.05). CONCLUSIONS: TIPS combined with embolization of gastric coronary veins could reduce significantly the rate of rebleeding in 1 year after the shunt placement as compared with TIPS alone.