The Treatment of Hepatocirrhosis and Portal Hypertension

Launched by YANJING GAO · May 17, 2016

Keywords

ClinConnect Summary

Endoscopic therapy is the mature treatment of gastroesophageal variceal haemorrhage and PSE is an effective method for treatment of the hypersplenism and portal hypertension. Existing researches show that endoscopic therapy + PSE is more effective than endoscopic therapy alone in prevention of esophageal varices bleeding recurrence in the patients with liver cirrhosis. However, there is few articles which proved long-term effectiveness of endoscopic therapy + PSE, it needs further research on this issue. This study compares the efficiency of partial splenic embolization +endoscopic therapy ...

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patients aged between 18 and 75 years
• • Patients who had recovered from an episode of VH or patients who had survived from acute VH and there was no bleeding for consecutive 5 days
• • Patients with a diagnosis of liver cirrhosis and portal hypertension on clinical examination, laboratory test, and imaging or histological examination
• • Patients with hypersplenism and thrombocytopenia (platelets \< 100,000/µL).
• Exclusion criteria :
• • Previous therapy (splenectomy, PSE, EVL, tissue adhesive injection, or usage of (NSBB) to prevent rebleeding
• • Bleeding from isolated gastric or ectopic varices
• • Hepatocellular carcinoma or other malignant tumors
• • Contraindications for the use of NSBBs, hepatic failure, and Child-Pugh class C with large amount ascites, or grade 3-5 hepatic encephalopathy, or prothrombin activity ≤ 40%
• • Hepatic failure
• • Contraindications for PSE
• • Pregnancy and lactation
• • Inability to sign the informed consent.