A meta-analysis of transjugular intrahepatic portosystemic shunt with or without embolization for esophageal and gastric variceal bleeding in decompensated liver cirrhosis.
Xiongtao Ma, Xinyan Yu, Qingping Wu et al.
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In 30 seconds
This meta-analysis evaluated the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) with or without embolization in 3079 patients with decompensated liver cirrhosis experiencing esophageal and gastric variceal bleeding. The study found that TIPS combined with embolization significantly reduced the rebleeding rate (risk ratios = 0.67; P < 0.001) and the incidence of hepatic encephalopathy compared to TIPS alone, although survival rates were similar.
Key findings
- Rebleeding rate was lower in the TIPS plus embolization group (risk ratios = 0.67; P < 0.001).
- In patients with gastric variceal bleeding, the rebleeding rate was significantly reduced (risk ratios = 0.50; P < 0.001).
- The incidence of hepatic encephalopathy was lower in the TIPS plus embolization group (risk ratios = 0.82; P < 0.001).
- No significant difference in survival rates was observed between the two groups (risk ratios = 1.00; P = 0.94).
Why it matters
Understanding the comparative effectiveness of TIPS with and without embolization can guide clinicians in managing variceal bleeding in patients with decompensated liver cirrhosis, potentially improving patient outcomes related to rebleeding and hepatic encephalopathy.