ePTFE-TIPS vs repetitive LVP plus albumin for the treatment of refractory ascites in patients with cirrhosis
| Autor: | Maria Schoder, Michael Trauner, Sophie Hoffman, Mattias Mandorfer, Arnulf Ferlitsch, Josef Karner, F Karnel, Thomas Reiberger, Markus Peck-Radosavljevic, Alexander Stadlmann, Theresa Bucsics, Philipp Schwabl, Wolfgang Matzek, Johanna Grünberger |
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| Rok vydání: | 2017 |
| Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Cirrhosis Portal venous pressure Serum albumin Gastroenterology Tertiary Care Centers 03 medical and health sciences 0302 clinical medicine Coated Materials Biocompatible Recurrence Risk Factors Internal medicine Albumins Ascites medicine Paracentesis Humans Diuretics Hepatic encephalopathy Polytetrafluoroethylene Aged Proportional Hazards Models Retrospective Studies Hepatology biology medicine.diagnostic_test business.industry Odds ratio Middle Aged medicine.disease Treatment Outcome 030220 oncology & carcinogenesis Hepatocellular carcinoma Austria Hepatic Encephalopathy biology.protein 030211 gastroenterology & hepatology Female Stents medicine.symptom Portasystemic Shunt Transjugular Intrahepatic business |
| Zdroj: | Liver international : official journal of the International Association for the Study of the Liver. 38(6) |
| ISSN: | 1478-3231 |
| Popis: | Introduction Reduction of portal pressure by self-expandable polytetrafluoroethylene (ePTFE)-covered transjugular intrahepatic portosystemic shunts (TIPS) is a treatment option for refractory ascites. Data on clinical outcomes after ePTFE-TIPS versus repetitive large-volume paracentesis (LVP) plus albumin (A) administration for the treatment of patients with refractory ascites are limited. Methods Retrospective comparison of ePTFE-TIPS versus LVP+A in terms of (i) control of ascites, (ii) occurrence of overt hepatic encephalopathy (HE) and (iii) transplant-free survival in cirrhotic patients with refractory ascites. Results Among n=221 patients with cirrhosis and refractory ascites, n=140 received ePTFE-TIPS and were compared to n=71 patients undergoing repetitive LVP+A. After ePTFE-TIPS, ascites was controlled without any further need for paracentesis in n=76 (54%; n=7 without and n=69 with diuretics). The need for frequent large-volume paracentesis was significantly higher in the LVP+A group than with ePTFE-TIPS (median 0.67 (IQR 0.23-2.63) months vs. 49.5 (IQR 5.07-102.60) months until paracentesis, log-rank p |
| Databáze: | OpenAIRE |
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