Variceal bleeding is a consequence of severe portal hypertension in patients with liver cirrhosis. Although the rate of bleeding has decreased over time, variceal bleeding in the presence of acute-on-chronic liver failure (ACLF) carries a high risk of treatment failure and short-term mortality. Treatment and/or removal of precipitating events (mainly bacterial infection and alcoholic hepatitis) and decrease of portal pressure may improve outcome of patients with acute decompensation or ACLF. Transjugular intrahepatic portosystemic shunts (TIPSs), especially in the preemptive situation, have been found to efficiently control bleeding, prevent rebleeding, and reduce short-term mortality. Therefore, TIPS placement should be considered in the management of ACLF patients with variceal bleeding.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1055/a-2107-0576 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Electronic Interventions to Improve Quality for Inpatient Cirrhosis Care: a prospective evaluation.
Am J Gastroenterol
January 2025
Division of Gastroenterology and Hepatology, University of Michigan.
Background: Efforts to improve adherence to quality measures in cirrhosis care are encouraged by AASLD to improve clinical outcomes.
Methods: We prospectively evaluated two best practice advisory (BPA) interventions to alert clinicians caring for patients with cirrhosis and acute variceal hemorrhage (AVH) or spontaneous bacterial peritonitis (SBP).
Results: Our BPAs increased utilization.
Machine learning prediction of hepatic encephalopathy for long-term survival after transjugular intrahepatic portosystemic shunt in acute variceal bleeding.
World J Gastroenterol
January 2025
Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou 510151, Guangdong Province, China.
Background: Transjugular intrahepatic portosystemic shunt (TIPS) is an effective intervention for managing complications of portal hypertension, particularly acute variceal bleeding (AVB). While effective in reducing portal pressure and preventing rebleeding, TIPS is associated with a considerable risk of overt hepatic encephalopathy (OHE), a complication that significantly elevates mortality rates.
Aim: To develop a machine learning (ML) model to predict OHE occurrence post-TIPS in patients with AVB using a 5-year dataset.
Five-year complete remission of super-giant hepatocellular carcinoma with hepatectomy followed by sorafenib plus camrelizumab: A case report.
World J Gastrointest Surg
January 2025
Department of Gastroenterology and Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China.
Background: Cirrhotic patients with super-giant hepatocellular carcinoma (HCC) and portal vein invasion generally have a poor prognosis. This paper presents a patient with super-giant HCC and portal vein invasion, who underwent hepatectomy followed by a combination of sorafenib and camrelizumab, resulting in complete remission (CR) for 5 years.
Case Summary: A 40-year-old male with compensated hepatitis B-related cirrhosis was diagnosed with HCC, Barcelona Clinic Liver Cancer stage C.
Trans-jugular intrahepatic portosystemic stent shunting benefits and limits.
World J Gastrointest Surg
January 2025
Department of Surgery, Gastroenterology and Digestive Endoscopy Unit, ASST Santi Paolo e Carlo, University of Milan, Milan 20142, Lombardy, Italy.
Trans-jugular intrahepatic portosystemic stent shunting (TIPSS) has been in use for many years with great results and many evolutions. The procedure essentially involves the insertion of a metal covert stent to create an Hepato-Hepatic portosystemic shunt. Over time, TIPSS has become the subject of many studies aimed at examining its clinical utility and evaluating the results of using TIPSS to manage complications related to portal hypertension.
View Article and Find Full Text PDFRisk of Variceal Bleeding in Patients Receiving Atezolizumab-Bevacizumab Treatment for Hepatocellular Carcinoma.
Aliment Pharmacol Ther
January 2025
Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Background And Aims: Real-world data on the variceal bleeding (VB) risk in patients receiving atezolizumab-bevacizumab (Atezo-Bev) treatment remain limited. This study aimed to assess the risk of VB and identify risk factors in patients with advanced hepatocellular carcinoma (HCC) receiving Atezo-Bev treatment.
Methods: This retrospective study included 640 patients with HCC who underwent endoscopy before Atezo-Bev treatment at two hospitals in Korea.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!