Transjugular intrahepatic portosystemic shunt in refractory ascites: a meta-analysis.
Détails
ID Serval
serval:BIB_B7A30296523A
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Transjugular intrahepatic portosystemic shunt in refractory ascites: a meta-analysis.
Périodique
Liver International
ISSN
1478-3223 (Print)
ISSN-L
1478-3223
Statut éditorial
Publié
Date de publication
2005
Volume
25
Numéro
2
Pages
349-356
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article ; ReviewPublication Status: ppublish. pdf type: Clinical Studies
Résumé
Transjugular intrahepatic portosystemic shunt (TIPS) is a more effective treatment for refractory ascites than large volume paracentesis (LVP), but the magnitude of its effect in terms of control of ascites, encephalopathy and survival has not been established.
AIM: This meta-analysis compare TIPS to LVP in terms of control of ascites at 4 and 12 months, encephalopathy and survival at 1 and 2 years.
RESULTS: Five randomized controlled trials involving 330 patients were included. In the TIPS group, control of ascites was more frequently achieved at 4 months (66% vs 23.8%, mean difference: 41.4%, 95% confidence interval (CI): 29.5-53.2%, P < 0.001) and 12 months (54.8% vs 18.9%, mean difference: 35%, 95% CI: 24.9-45.1%, P < 0.001), whereas encephalopathy was higher (54.9% vs 38.1%, mean difference: 17%, 95% CI: 7.3-26.6%, P < 0.001). Survival at 1 year (61.7% vs 56.5%, mean difference: 3.2%, 95% CI: -14.7 to 21.9%) and 2 years (50% vs 42.8%, mean difference: 6.8%, 95% CI: -10 to 23.6%) were not significantly different.
CONCLUSIONS: TIPS is a more effective treatment for refractory ascites than LVP. However, TIPS increase encephalopathy and does not improve survival.
AIM: This meta-analysis compare TIPS to LVP in terms of control of ascites at 4 and 12 months, encephalopathy and survival at 1 and 2 years.
RESULTS: Five randomized controlled trials involving 330 patients were included. In the TIPS group, control of ascites was more frequently achieved at 4 months (66% vs 23.8%, mean difference: 41.4%, 95% confidence interval (CI): 29.5-53.2%, P < 0.001) and 12 months (54.8% vs 18.9%, mean difference: 35%, 95% CI: 24.9-45.1%, P < 0.001), whereas encephalopathy was higher (54.9% vs 38.1%, mean difference: 17%, 95% CI: 7.3-26.6%, P < 0.001). Survival at 1 year (61.7% vs 56.5%, mean difference: 3.2%, 95% CI: -14.7 to 21.9%) and 2 years (50% vs 42.8%, mean difference: 6.8%, 95% CI: -10 to 23.6%) were not significantly different.
CONCLUSIONS: TIPS is a more effective treatment for refractory ascites than LVP. However, TIPS increase encephalopathy and does not improve survival.
Mots-clé
Aged, Ascites/diagnosis, Ascites/mortality, Female, Follow-Up Studies, Hepatic Encephalopathy/diagnosis, Hepatic Encephalopathy/mortality, Humans, Liver Function Tests, Male, Middle Aged, Portasystemic Shunt, Transjugular Intrahepatic/methods, Randomized Controlled Trials as Topic, Recurrence, Risk Assessment, Sensitivity and Specificity, Severity of Illness Index, Survival Rate, Treatment Outcome
Pubmed
Web of science
Création de la notice
06/12/2013 11:25
Dernière modification de la notice
20/08/2019 16:25
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