Portosystemic shunts versus endoscopic intervention with or without medical treatment for prevention of rebleeding in people with cirrhosis

Simonetti, Rosa G; Robbins, Helen L.; Battula, Narendra; Weickert, Martin O.; Khan, Saboor

doi:10.1002/14651858.cd000553.pub3

Cited by 3 publications

(2 citation statements)

References 112 publications

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“…Different therapeutic procedures are used including drug treatments (non-cardio selective beta-blockers, or isosorbide mononitrate or both), endoscopic interventions (ligation of oesophageal varices, or sclerotherapy), blood shunts (total shunt, transjugular portosystemic or distal splenorenal shunt). The superiority of an intervention over another has not been demonstrated [30]. However, the best treatment remains the prevention by treating the cause of the cirrhosis (alcohol withdrawal or effective antiviral treatment) [31].…”

Section: Symptomatic Treatmentmentioning

confidence: 99%

Cirrhosis: Therapeutic Aspects and Outcome for Hospitalized Patients in Burkina Faso

Somé¹,

Nana²,

Lompo³

et al. 2021

OJEpi

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Introduction: Cirrhosis represents 27.63% of the hepatobiliary diseases in Burkina Faso. We aimed at studying the therapeutic and evolutionary features of the cirrhosis. Patients and methods: We implemented a cross-sectional and descriptive study, collecting retrospectively the data from 1st January 2012 to 31st March 2014. The diagnosis of cirrhosis was based on 1) clinical criteria (an edema-ascitic syndrome with a heterogeneous hepatomegaly with a sharp inferior border or atrophic liver and a portal hypertension); 2) biological criteria (a hepatocellular insufficiency syndrome); and 3) ultrasound imaging suggesting cirrhosis. Qualitative variables were presented as frequencies and percentages while quantitative ones were presented as means. Results: The data of 273 patients representing 33.9% of all hospitalizations were analyzed. The hepato-biliary diseases represented 74.7% of all diagnosis. The participants' mean age was 46.9 years and the sex ratio, 2.7. The HBs antigen and anti-HCV antibodies were positive in 76.5% and 14.6% of the cases, respectively. Ascites was treated with puncture in 40.2% of patients, a salt-free diet (38.8%) and diuretics (54.2%). Hepatic encephalopathy was treated with lactulose in 73.6% of patients and two patients (1.3%) underwent esophageal varices ligation to treat their gastrointestinal bleeding. Lamivudine, tenofovir, and lamivudine-tenofovir combination were administered to 57.4%, 32.8%, and 10% of HBs Antigen positive patients, respectively. Conclusion: Cirrhosis still mostly affects the young and active male population at the gastro-enterology department of the university teaching hospital Yalgado Ouédraogo. Patients show up at a very advanced stage of the disease in poorly prepared health centres. In this context, prevention by the anti-hepatitis B immunization and early systematic screening with treatment when indicated are very efficient weapons at our disposal.

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Section: Symptomatic Treatmentmentioning

confidence: 99%

Cirrhosis: Therapeutic Aspects and Outcome for Hospitalized Patients in Burkina Faso

Somé¹,

Nana²,

Lompo³

et al. 2021

OJEpi

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“…However, the superiority of bypass techniques, whether surgical or radiological, over iterative endoscopic treatment remains debated. The objective disadvantage of endoscopy is the need for multiple sessions, which limits its application in countries with constrained resources where patients do not have easy access to health care centers (3). Similarly, the cost and availability of recent interventional radiology shunt techniques also limits the use of these procedures in these same regions.…”

Section: Introductionmentioning

confidence: 99%

The use of autologous peritoneum in surgery of portal hypertension: H-shape splenorenal shunt using simple layer peritoneal tube

Terwagne¹,

Marique²,

Dieu³

et al. 2022

AGEB

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The management of portal hypertension complicated by iterative gastro-intestinal bleeding remains challenging, especially in a low-income environment. Interventional radiology and endoscopic treatments are not always accessible, and a definitive surgical option may prove to be lifesaving. We report a new technique of surgical portosystemic shunt that can be performed in all contexts. We describe the surgical technique of a H-shaped splenorenal shunt using autologous rolled up peritoneum as a vascular graft.

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How do portosystemic shunts compare with endoscopic interventions for prevention of rebleeding in adults with cirrhosis?

Gurusamy¹

2021

Cochrane Clinical Answers

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Portosystemic shunts versus endoscopic intervention with or without medical treatment for prevention of rebleeding in people with cirrhosis

Cited by 3 publications

References 112 publications

Cirrhosis: Therapeutic Aspects and Outcome for Hospitalized Patients in Burkina Faso

Cirrhosis: Therapeutic Aspects and Outcome for Hospitalized Patients in Burkina Faso

The use of autologous peritoneum in surgery of portal hypertension: H-shape splenorenal shunt using simple layer peritoneal tube

How do portosystemic shunts compare with endoscopic interventions for prevention of rebleeding in adults with cirrhosis?

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