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Comparison of treatment outcomes between balloon-occluded retrograde transvenous obliteration and transjugular intrahepatic portosystemic shunt for gastric variceal bleeding hemostasis

DC FieldValueLanguage
dc.contributor.author김경민-
dc.contributor.author김만득-
dc.contributor.author김승업-
dc.contributor.author박성일-
dc.contributor.author원종윤-
dc.contributor.author이광훈-
dc.contributor.author이도연-
dc.date.accessioned2018-07-20T07:47:55Z-
dc.date.available2018-07-20T07:47:55Z-
dc.date.issued2017-
dc.identifier.issn0815-9319-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/160533-
dc.description.abstractBACKGROUND AND AIM: Both balloon-occluded retrograde transvenous obliteration (BRTO) and transjugular intrahepatic portosystemic shunt (TIPS) are considered effective treatments for gastric variceal bleeding (GVB). In this study, outcomes of these two procedures were compared in managing patients with GVB. METHODS: A total of 142 patients undergoing BRTO (n = 95) or TIPS (n = 47) between 2005 and 2012 at two tertiary centers were selected for retrospective review. RESULTS: Mean patient age (male, 115; female, 27) was 58.1 years. Alcoholic liver cirrhosis was the most common underlying cause (n = 63, 44.4%), followed by hepatitis B (n = 60, 42.3%) and hepatitis C (n = 7, 4.9%) viral infections. Concurrent hepatocellular carcinoma (HCC) was identified in 64 (45.1%) patients. During the follow-up period (mean, 28.2 months), 27 patients (19%) experienced re-bleeding. Cumulative re-bleeding rates after BRTO (8.6% at 1 year; 22.7% at 3 years) were significantly lower than those after TIPS (19.8% at 1 year; 48.2% at 3 years; P = 0.006, log-rank test). In multivariate analysis, TIPS (vs BRTO) was found independently predictive of re-bleeding (hazard ratio [HR] = 2.174; P = 0.048), in addition to concurrent HCC and poor baseline Child-Pugh score (both P < 0.05). Although BRTO surpassed TIPS (P = 0.026, log-rank test) in terms of overall postprocedural survival, independent factors predictive of poor overall survival after hemostasis were concurrent HCC (HR = 3.106), high Child-Pugh score (HR = 1.886 per 1-point increase), and postprocedural hepatic encephalopathy (HR = 3.014; all P < 0.05). CONCLUSION: Balloon-occluded retrograde transvenous obliteration proved more effective than TIPS in hemostasis of GVB, associated with significantly less risk of re-bleeding.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherBlackwell Scientific Publications-
dc.relation.isPartOfJournal of Gastroenterology and Hepatology-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAged-
dc.subject.MESHBalloon Occlusion/methods*-
dc.subject.MESHEsophageal and Gastric Varices/complications*-
dc.subject.MESHFemale-
dc.subject.MESHGastrointestinal Hemorrhage/etiology*-
dc.subject.MESHGastrointestinal Hemorrhage/therapy*-
dc.subject.MESHHemostasis, Surgical/methods*-
dc.subject.MESHHepatitis B/complications-
dc.subject.MESHHepatitis C/complications-
dc.subject.MESHHumans-
dc.subject.MESHLiver Cirrhosis, Alcoholic/complications-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHPortasystemic Shunt, Transjugular Intrahepatic/methods*-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHTreatment Outcome-
dc.titleComparison of treatment outcomes between balloon-occluded retrograde transvenous obliteration and transjugular intrahepatic portosystemic shunt for gastric variceal bleeding hemostasis-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Radiology-
dc.contributor.googleauthorShin Jae Lee-
dc.contributor.googleauthorSeung Up Kim-
dc.contributor.googleauthorMan‐Deuk Kim-
dc.contributor.googleauthorYoung Hwan Kim-
dc.contributor.googleauthorGyoung Min Kim-
dc.contributor.googleauthorSung Il Park-
dc.contributor.googleauthorJong Yun Won-
dc.contributor.googleauthorDo Yun Lee-
dc.contributor.googleauthorKwang‐Hun Lee-
dc.identifier.doi10.1111/jgh.13729-
dc.contributor.localIdA00296-
dc.contributor.localIdA00420-
dc.contributor.localIdA00654-
dc.contributor.localIdA01510-
dc.contributor.localIdA02443-
dc.contributor.localIdA02676-
dc.contributor.localIdA02718-
dc.relation.journalcodeJ01417-
dc.identifier.eissn1440-1746-
dc.identifier.pmid28085232-
dc.identifier.urlhttps://onlinelibrary.wiley.com/doi/abs/10.1111/jgh.13729-
dc.subject.keywordballoon-occluded retrograde transvenous obliteration-
dc.subject.keywordgastric variceal bleeding-
dc.subject.keywordoutcome-
dc.subject.keywordoverall survival-
dc.subject.keywordre-bleeding-
dc.subject.keywordtransjugular intrahepatic portosystemic shunt-
dc.contributor.alternativeNameKim, Gyoung Min-
dc.contributor.alternativeNameKim, Man Deuk-
dc.contributor.alternativeNameKim, Seung Up-
dc.contributor.alternativeNamePark, Sung Il-
dc.contributor.alternativeNameWon, Jong Yun-
dc.contributor.alternativeNameLee, Kwang Hun-
dc.contributor.alternativeNameLee, Do Yun-
dc.contributor.affiliatedAuthorKim, Gyoung Min-
dc.contributor.affiliatedAuthorKim, Man Deuk-
dc.contributor.affiliatedAuthorKim, Seung Up-
dc.contributor.affiliatedAuthorPark, Sung Il-
dc.contributor.affiliatedAuthorWon, Jong Yun-
dc.contributor.affiliatedAuthorLee, Kwang Hun-
dc.contributor.affiliatedAuthorLee, Do Yun-
dc.citation.volume32-
dc.citation.number8-
dc.citation.startPage1487-
dc.citation.endPage1494-
dc.identifier.bibliographicCitationJournal of Gastroenterology and Hepatology, Vol.32(8) : 1487-1494, 2017-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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