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Balloon-compression endoscopic injection sclerotherapy versus transjugular intrahepatic portosystemic shunt for esophageal variceal rebleeding

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A Correction to this article was published on 30 May 2023

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Abstract

Background

In cirrhotic patients, recurrent bleeding after the first episode of esophageal variceal bleeding (EVB) is common and lethal. The present study was aimed to compare balloon-compression endoscopic injection sclerotherapy (bc-EIS) with transjugular intrahepatic portosystemic shunt (TIPS) for the prophylaxis of variceal rebleeding.

Methods

Between June 2020 and September 2022, 81 cirrhotic patients with EVB (42 in the bc-EIS group and 39 in the TIPS group) were evaluated retrospectively. The occurrence of rebleeding, hepatic encephalopathy (HE) or other complications, as well as liver functions and survival rate were compared between two groups.

Results

During the 12 months of follow-up, variceal eradication was achieved in 40 (95.24%) patients of the bc-EIS group after a mean of 1.80 ± 0.94 sessions. TIPS was successfully performed in 39 (100%) patients. No significant difference in the variceal rebleeding rate was observed between bc-EIS and TIPS groups (16.67 vs. 17.95%; p = 0.111). While the bc-EIS group showed significantly decreased incidence of HE (2.38 vs. 17.95%; p < 0.001) and lower level of total bilirubin (p < 0.05) in comparison with the TIPS group. The difference in mortality between the two groups failed to reach statistical significance (0.00 vs. 7.69%; p = 0.107).

Conclusion

Bc-EIS is not inferior to TIPS in the survival and control of variceal rebleeding, but associated with decreased risk of HE and liver dysfunction.

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Acknowledgements

We thank Mingquan Wang, Guobing Zhang, and all the staff at the Department of Gastroenterology and Department of Intervention Therapy for their contribution to this work.

Funding

The present study was supported by the sixth batch of appropriate technology for health promotion project of Anhui Provincial Health Commission (SYJS202103). The funders had no input in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Key Laboratory of Digestive Diseases of Anhui Province, Department of Gastroenterology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230022, Anhui Province, China

    Wenyue Wu, Fuming Zhang, Xuecan Mei, Qianqian Zhang, Jing Jin & Derun Kong

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  1. Wenyue Wu
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  2. Fuming Zhang
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  3. Xuecan Mei
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Contributions

WW and DK designed the study; WW, FZ, QZ, and JJ collected the data, WW and XM made statistical analysis and drafting the manuscript. DK revised the manuscript.

Corresponding author

Correspondence to Derun Kong.

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Wenyue Wu, Fuming Zhang, Xuecan Mei, Qianqian Zhang, Jing Jin, and Derun Kong have no conflicts of interest or financial ties to disclose.

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Wu, W., Zhang, F., Mei, X. et al. Balloon-compression endoscopic injection sclerotherapy versus transjugular intrahepatic portosystemic shunt for esophageal variceal rebleeding. Surg Endosc 37, 5766–5774 (2023). https://doi.org/10.1007/s00464-023-10085-y

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