The effects of transjugular intrahepatic portosystemic shunt on portal hypertensive gastropathy

被引：54

作者：

Urata, J ^{[1
]}

Yamashita, Y ^{[1
]}

Tsuchigame, T ^{[1
]}

Hatanaka, Y ^{[1
]}

Matsukawa, T ^{[1
]}

Sumi, S ^{[1
]}

Matsuno, Y ^{[1
]}

Takahashi, M ^{[1
]}

机构：

[1] Kumamoto Univ, Sch Med, Dept Radiol, Kumamoto 860, Japan

来源：

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY | 1998年 / 13卷 / 10期

关键词：

oesophagogastric varices; portal hypertensive gastropathy; transjugular intrahepatic portosystemic shunt;

D O I：

10.1111/j.1440-1746.1998.tb00571.x

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

In addition to variceal bleeding, haematemesis may occur due to haemorrhagic gastritis in patients with portal hypertension. This has been known as portal hypertensive gastropathy (PHG). We have evaluated the effects of the transjugular intrahepatic portosystemic shunt (TIPS) on portal venous pressure (PVP) and endoscopic gastric mucosal changes observed in patients with portal hypertension. We performed TIPS in 12 patients with complications due to portal hypertension as follows: variceal bleeding in nine patients (bleeding from oesophageal varices in seven and gastric varices in two), refractory ascites in three and haemorrhage from severe PHG in one. Endoscopic examinations were performed before and after TIPS for all patients. Changes of PVP and gastric mucosal findings on endoscopy were analysed. Before TIPS, PHG was seen in 10 patients. Portal venous pressure decreased from an average of 25.1 +/- 8.8 to 17.1 +/- 6.2 mmHg after TIPS (P < 0.005). On endoscopy, PHG improved in nine of 10 patients. Oesophagogastric varices improved in eight of 11 patients. In one patient with massive haematemesis, haemorrhage from severe PHG completely stopped after TIPS. Because TIPS effectively reduced PVP, this procedure appeared to be effective for the treatment of uncontrollable PHG.

引用

页码：1061 / 1067

页数：7

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