Portosystemic shunts versus endoscopic therapy for variceal rebleeding in patients with cirrhosis

Abstract

Portosystemic shunts versus endoscopic therapy for variceal rebleeding in patients with cirrhosis.

Surgical shunts compared with endoscopic sclerotherapy for the treatment of variceal bleeding in adults with portal hypertension: a systematic review and meta-analysis

“…Our findings are comparable to the results of a previous meta-analysis by Khan et al 37 that compared the efficacy of surgical shunts (total surgical stunts: distal spleno-renal shunts (DSRS) or TIPS) and endoscopic therapy (sclerotherapy and/or banding) for the prevention of rebleeding in patients with cirrhosis 37. Their study included 22 trials with 1409 patients.…”

Endoscopic Diagnosis and Therapy in Gastroesophageal Variceal Bleeding

“…TIPS is rapidly becoming a front line approach for secondary prophylaxis and should be considered especially among patients with high risks of treatment failure with EVBL. 29-31 In its absence, a combination of EVBL and nonselective beta blockers constitutes the standard of care of prevention of variceal rebleeding. Multiple trials have evaluated and demonstrated that combination therapy is superior to either EVBL alone or pharmacological therapy alone for secondary prophylaxis.…”

Evaluation of the quality of clinical practice guidelines for the management of esophageal or gastric variceal bleeding

“…The guideline has been piloted among target users Rigor of development (items [8][9][10][11][12][13][14] 8. The average score was 78.1 (median 82.3, range 46-100).…”

“…Endoscopic methods [6][7][8], vasoactive drugs [9][10][11], radiological interventions [12], and surgical procedures [13,14] improve the prognosis of acute bleeding episodes, with a decrease in immediate mortality due to bleeding. However, the short-term and medium-term effectiveness of these interventions is still being evaluated [15,16].…”