[Treatment of uncontrollable hemorrhage caused by esophageal varices in cirrhotics. Transhepatic embolization or emergency portal shunt].
The purpose of this study was to compare the results of two therapeutic methods used in an emergency to control oesophageal variceal bleeding resistant to medical treatment in cirrhotic patients: portal diversion (116 patients) or transhepatic embolization of the varices (84 patients). Portal diversion proved more effective in stopping the haemorrhage than embolization but the overall mortality rate was about the same with the two procedures. An analysis of the results taking into account the patient's condition failed to show any difference in mortality between the two methods. Indeed, the very high mortality rate in the most severely ill patients may oblige to question their usefulness in such cases. In the least severe patients, we prefer portal diversion which is quicker and can be performed at any time. In patients of the intermediate group transhepatic embolization seems to be less hazardous than portal diversion.
D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000401:mortality; D004630:Emergencies; D004932:Esophageal and Gastric Varices / Q000150:complications*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D011167:Portacaval Shunt, Surgical / Q000009:adverse effects / Q000401:mortality; D012008:Recurrence; D012422:Rupture, Spontaneous
Traitement des hémorragies incontrôlables dues aux varices oesophagiennes chez le cirrhotique. Embolisation transhépatique ou dérivation portale d'urgence.