[Treatment of hemorrhagic congestive gastropathy with TIPS implantation. Pilot study].
Minimally invasive percutaneous procedures has an important place in internal medicine. In this concept is included a transjugular intrahepatic portosystemic shunts (TIPS). In this pilot study we describe the indication of this therapeutic modality in three cirrhotic patients with hemorrhagic congestive gastropathy unresponsive to infusion of drugs that reduce the portal pressure. All of them were treated by TIPS and control of gastric bleeding occurred in all. One of these showed partial stenosis of the wallstent, treated by prosthesis dilatation. Another developed portosystemic encephalopathy controlled by usual therapeutic measures in the other we implanted two TIPS to obtain a low pressure level of the hepatic-portal gradient. They had no further necessity of blood transfusion, with better hemodynamic conditions and biochemical tests with reduction of the values of the GHP. We conclude that TIPS may be useful to treat hemorrhagic congestive gastropathy acting like a bridge for subsequent elective liver transplantation under good clinical and hemodynamic conditions.
de Oliveira e Silva
A
A
Centro Terapêutico Especializado em Fígado (CETEFI), do Hospital São Joaquim da Beneficência Portuguesa de São Paulo.
Cardoso
E S
ES
dos Santos
T E
TE
de Melo
C R
CR
Teixeira
A C
AC
Mourão
G S
GS
D'Albuquerque
L A
LA
D000328:Adult; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D006503:Hepatic Veins / Q000000981:diagnostic imaging; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010690:Phlebography; D010865:Pilot Projects; D011169:Portal Vein / Q000000981:diagnostic imaging; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011172:Portography; D013272:Stomach Diseases / Q000601:surgery*
Tratamento da gastropatia congestiva hemorrágica através do implante do TIPS. Estudo piloto.