Danis oesophageal stent in treatment of variceal bleeding
Authors:
T. Fejfar 1; V. Šafka 2; V. Jirkovský 1; P. Hůlek 1
Authors‘ workplace:
II. interní gastroenterologická klinika FN Hradec Králové
1; Ústav fyziologie, LF UK v Hradci Králové
2
Published in:
Gastroent Hepatol 2013; 67(2): 98-103
Category:
Hepatology: Review article
Overview
Acute oesophagealvariceal bleeding is still a serious and life-threatening complication of symptomatic portal hypertension. Despite the current treatment with volume expansion, appropriate hemosubstitution, broad-spectrum antibiotics, vasoactive drugs and endoscopic treatment, it is still associated with high risk of failure and early relapse. Balloon tamponade or portosystemic shunt creation are the potential salvage therapies. The use of a special coated self-expandable metal oesophageal stent as an alternative to balloon tamponade, or in cases of contraindications to portosystemic shunt creation, has been supported by more data in the last decade.
Key words:
portal hypertension – variceal bleeding – therapy – stent
Sources
1. North Italian Endoscopic Club for Study and Treatment of Esophageal Varices. Prediction of the first variceal haemorrhage in patiens with cirrhosis of the liver and esophageal varices. A prospective multicentre study. N Engl J Med 1988; 319(15): 983–989.
2. De Franchis R et al. Portal Hypertension V: Proceedings of the Fifth Baveno International Consensus Workshop. London: Wiley-Blackwell press 2011.
3.Working group for portal hypertension at the Czech Society of Hepatology, Czech Medical Association of J. E. Purkyně, Bruha R et al. Guidelines on the diagnosis and treatment of bleeding into the digestive tract caused by portal hypertension. Gastroent Hepatol 2001; 65(3): 141–142.
4. de Franchis R, Baveno V Faculty. Revising connsensus in portal hypertension: Report of the Baveno V consensus workshop on metodology of diagnosis and therapy in portal hypertension. J Hepatol 2010; 53(4): 762–768.
5. Boyer TD, Haskal ZJ, American Association for the Study of Liver Diseases. The Role of Transjugular Intrahepatic Portosystemic Shunt (TIPS) in the Management of Portal Hypertension: update 2009. Hepatology 2010; 51(1): 306.1-16.
6. Hulek P, Krajina A et al. Current Practice of TIPS. Hradec Králové: Olga Štambergová 2001.
7. Krajina A, Hulek P, Fejfar T et al. Quality improvement guidelines for Transjugular Intrahepatic Portosystemic Shunt (TIPS). Cardiovasc Intervent Radiol 2012; 35(6): 1295–1300.
8. Sengstaken RW, Blakemore AH. Balloon tamponage for the control of hemorhagie from esophageal varices. Ann Surg 1950; 131(5): 781–789.
9. Bosch J, Berzigotti A, Garcia-Pagan JC et al. The management of portal hypertension: rational basis, available treatments and future options. J Hepatol 2008; 48 (Suppl 1): S68–92.
10. D'Amico G, Pagliaro L, Bosch J. The treatment of portal hypertension: a meta-analytic review. Hepatology 1995; 22(1): 332–354.
11. Collyer TC, Dawson SE, Earl D. Acute upper airway obstruction due to displacement of a Sengstaken-Blakemore tube. Eur J Anaesthesiol 2008; 25(4): 341–342.
12. McDonald JWD, Burroughs AK, Feagan BG et al. Portal hypertensive bleeding In: Evidence-Based Gastroenterology and Hepatology. London: Wiley-Blackwell press 2011: 579–580.
13. Hubmann R, Bodlaj G, Czompo M et al. The use of self-expanding metal stents to treat acute esophageal variceal bleeding. Endoscopy 2006; 38(9): 896–901.
14. Zehetner J, Shamiyeh A, Wayand W et al. Results of a new method to stop acute bleeding from esophageal varices: implantation of a self-expanding stent. Surg Endosc 2008; 22(10): 2149–2152.
15. Wright G, Lewis H, Hogan B et al. A self-expanding metal stent for complicated variceal hemorrhage: experience at a single center. Gastrointest Endosc 2010; 71(1): 71–78.
16. Dechen A, El Fouly AH, Bechmann LP et al. Acute management of refractory variceal bleeding in liver cirrhosis by self-expanding metal stent. Digestion 2012; 85(3):185–191.
17. Dechene A, Adamzik M, Gerken G et al. Bronchial obstruction following esophageal stent implantation. Endoscopy 2009; 41 (Suppl 2): E146–E147.
18. Mishin I, Ghidirim G, Dolghii A et al. Implantation of self-expanding metal stent in the treatment of severe bleeding from esophageal ulcer after endoscopic band ligation. Dis Esophagus 2010; 23(7): E35–38.
19. Matull WR, Cross TJ, Yu D et al. A removable covered self-expanding metal stent for the management of Sengstaken-Blakemore tubeinduced esophageal tear and variceal hemorrhage. Gastrointest Endosc 2008; 68(4): 767–768.
20. Kaya E, Lenz P, Lebiedz P et al. Placement of covered self-expanding metal stent to treat razor blade-induced esophageal hemorrhage. Endoscopy 2010; 42 (Suppl 2): E201–202.
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