Nghiên cứu đặc điểm chảy máu tiêu hóa tái phát ở bệnh nhân xơ tăng tăng áp lực tĩnh mạch cửa được điều trị bằng phương pháp tạo shunt cửa - chủ trong gan (TIPS)

Objectives: To evaluate the characteristics and factors related of gastro-oesophageal variceal rebleeding after TIPS therapy. Subjects and methods: From September 2009 to June 2013, 64 patients with portal hypertensive cirrhotic liver disease complicated by recurrent variceal bleeding were treated with TIPS therapy. the authors evaluated pre- and post- operative portal pressure, porto-systemic pressure gradient, rebleeding complication and factors related. Results: Immediate reduction of portal presure from 32.6:+/- 5.7 mmHg to 22.7 +/- 5.7 mmHg, reduction of portosystemic gradient from 20.0 +/- 4.9 mmHg to 5.3 +/- 3.5 mmHg. The rate of gastro-oesophagieal variceal rebleeding was 25 percent, mortality rate in rebleeding group was 31.2 percent. Rebleeding after TIPS was related to the shunt stenosis and occlusion, portosystemic gradient after TIPS (p 0.05) and was not related the Child-Pugh classification. Conclusion: TIPS is a therapy of efficacy resulting in reduction of portal hypertention and control of recurrent bleeding from variceal rupture in portal hypertensive cirrhotic liver patients. the authors need careful follow-up surveillance and shunt revision TIPS is a very effective therapeutic strategy for the control of variceal bleeding.