The effects of transjugular intrahepatic portosystemic shunt on portal hypertensive gastropathy
Article first published online: 28 JUN 2008
Journal of Gastroenterology and Hepatology
Volume 13, Issue 10, pages 1061–1067, October 1998
How to Cite
URATA, J., YAMASHITA, Y., TSUCHIGAME, T., HATANAKA, Y., MATSUKAWA, T., SUMI, S., MATSUNO, Y. and TAKAHASHI, M. (1998), The effects of transjugular intrahepatic portosystemic shunt on portal hypertensive gastropathy. Journal of Gastroenterology and Hepatology, 13: 1061–1067. doi: 10.1111/j.1440-1746.1998.tb00571.x
- Issue published online: 28 JUN 2008
- Article first published online: 28 JUN 2008
- Accepted for publication 19 January 1998.
- oesophagogastric varices;
- portal hypertensive gastropathy;
- transjugular intrahepatic portosystemic shunt.
In addition to variceal bleeding, haematemesis may occur due to haemorrhagic gastritis in patients with portal hypertension. This has been known as portal hypertensive gastropathy (PHG). We have evaluated the effects of the transjugular intrahepatic portosystemic shunt (TIPS) on portal venous pressure (PVP) and endoscopic gastric mucosal changes observed in patients with portal hypertension. We performed TIPS in 12 patients with complications due to portal hypertension as follows: variceal bleeding in nine patients (bleeding from oesophageal varices in seven and gastric varices in two), refractory ascites in three and haemorrhage from severe PHG in one. Endoscopic examinations were performed before and after TIPS for all patients. Changes of PVP and gastric mucosal findings on endoscopy were analysed. Before TIPS, PHG was seen in 10 patients. Portal venous pressure decreased from an average of 25.1 ± 8.8 to 17.1 ± 6.2 mmHg after TIPS (P < 0.005). On endoscopy, PHG improved in nine of 10 patients. Oesophagogastric varices improved in eight of 11 patients. In one patient with massive haematemesis, haemorrhage from severe PHG completely stopped after TIPS. Because TIPS effectively reduced PVP, this procedure appeared to be effective for the treatment of uncontrollable PHG.