Risk factors analysis of endoscopy and TIPS in the treatment of secondary esophagogastric varicose bleeding with cirrhosis

Abstract

Objective: To analyse the risk factors of secondary hemorrhage and survival rate in cirrhotic patients with esophagogastric varicealrupture and to compare the efficacy and safety of endoscopic hemostasis and TIPS (transjugular intrahepatic portosystemicshunt). Methods: A total of 120 patients with secondary bleeding after endoscopic treatment of esophagogastric varicose bleeding withcirrhosis in our hospital during the past 3 years were retrospectively analysed. There were 65 males and 55 females, ranging inage from 49 to 74 years old, with an average of (59.5 ± 8.4) years old. The etiology, degree of varicose veins, bleeding location,hemostasis method, Infection, ascites, portal vein thrombosis or cancer thrombus, albumin, platelets, prothrombin activity, ChildPugh (Child-Pugh classification is a diagnostic criterion for liver reserve function) grade were compared in each group. The riskfactors of treatment failure and analyse the survival time was analysed. Results: There were statistically significant differences in varicosis degree, infection, ascites, portal vein thrombosis or cancerthrombus, child Pugh grade, albumin and prothrombin activity between the failed Endoscopy group and the successful hemostasisgroup (P< 0.05). There were statistically significant differences in child Pugh grade, albumin and prothrombin activity betweenthe failed TIPS treatment group and successful hemostasis group (P< 0.05). There was no significant difference in 1-yearsurvival between the endoscopy group and the TIPS group. Conclusion: Severe varicose veins, infection, ascites, portal vein thrombosis or cancer thrombus, child pugh classification, albumin,and prothrombin activity were the major risk factors for failed secondary endoscopic therapy, child Pugh classification,albumin and prothrombin activity were the main risk factors for failure TIPS treatment. There is no significant difference inlong-term survival between the two methods. Keywords: Liver cirrhosis; esophagogastric varicose bleeding; Endoscopy; TIPS.