TIPS, endoscopic treatment, variceal bleeding (TIPS, endoscopische behandeling, varices bloedingen)
Conditions
Interventions
Transjugular Intrahepatic Porto-systemic Shunt (TIPS)(intervention group): a shunt is made between the portal vein and the systemic veins, which decreases blood pressure in the portal vein to normal.
Sponsors
Erasmus MC, department of Radiology and Department of Gastro-enterology
Eligibility
Inclusion criteria
Inclusion criteria: 1. Patients presenting with a first or second episode of esophageal or gastric variceal bleeding, as documented by endoscopy and meeting accepted diagnostic criteria; 2. Initial stabilization (absence of evidence of continued bleeding); 3. Informed consent; 4. Age > 18 and < 76 years
Exclusion criteria
Exclusion criteria: 1. History of serious or refractory encephalopathy, unrelated to gastrointestinal bleeding; 2. History of significant heart failure (NYHA class III & IV); 3. Portal hypertension due to other causes than liver disease (e.g. portal vein or splenic vein thrombosis); 4. Previous TIPS placement; 5. Advanced hepatocellular carcinoma; 6. Severely compromised liver function (Child-Pugh score >13); 7. Sepsis and/or multiorgan failure
Design outcomes
Secondary
| Measure | Time frame |
|---|---|
| 1. Occurrence of treatment failure (either switch to other therapy -“cross-over”- or death); 2. Incidence of encephalopathy, defined as occurrence of grade II, III or IV encephalopathy; 3. Liver function (according to Child-Pugh class); 4. Mortality; 5. Quality of life; 6. Costs | — |
Primary
| Measure | Time frame |
|---|---|
| Recurrence of variceal bleeding | — |
Contacts
Public ContactE.J. Kuipers
Erasmus MC, University Medical Center Rotterdam Department of Gastroenterology and Hepatology
Outcome results
None listed