Portasystemic shunt vs gastroesophageal devascularization for treatment of portal hypertension: one Meta-analysis

doi:10.3760/cma.j.issn.1674-0793.2010.01.124

Abstract

Abstract:

Objective

To systematically evaluate the therapeutic effect of portasystemic shunt (PSS) and gastroesophageal devascularization (GD) on portal hypertension (PH) after liver cirrhosis.

Methods

The literatures about the therapeutic effect of PSS and GD on PH after cirrhosis were collected from Medline, Elsevier, China National Knowledge Infrastructure (CNKI) and Wanfang databases from 1989 to 2008. RevMan 5.0 software was used for data analysis.

Results

According to the included criteria, 10 clinical trials were selected finally. The combined results of Meta-analysis with fixed effect model showed that the Operative Mortality was similar [RR=1.04, 95% CI(0.74-1.47), P >0.05]; Recurrent variceal bleeding rate of PSS was lower than GD[RR=0.48, 95% CI(0.39-0.59), P<0.01]; Encephalopathy rate of PSS was higher than GD[RR=2.85, 95% CI(2.14-3.80), P<0.01], while post operative mortality of PSS was higher than GD[RR=1.25, 95% CI(1.01-1.55), P<0.05].

Conclusion

PSS and GD may be used in the treatment of PH, but in comparing with PSS, GD has a better effect on PH after cirrhosis.

Key words: Hypertension, portal, Treatment, Varicose vein, Hepatic encephalopathy, Mortality, Meta- analysis

An JIANG, Zong-fang LI, Zhi-dong WANG, Rui ZHOU, Yi-ming LI, Zheng-an YANG, Yan-song PU, Yan-feng GUO. Portasystemic shunt vs gastroesophageal devascularization for treatment of portal hypertension: one Meta-analysis[J]. Chinese Archives of General Surgery(Electronic Edition), 2010, 04(01): 76-81.

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References 14

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研究者，发表年份	n/n	年龄(岁)	男(例)	病因学(例)	随访时间(年)
研究者，发表年份	n/n	(±s)	(n/n)	(乙型肝炎/其他)	随访时间(年)
Farouk A, et al，1989^[3]	123/96	36±11/36±11	120/87	131/88	6.8/6.5
Borgonovo G, et al，1996^[4]	27/27	53.6±9.3/51.0±9.4	21/22	11/43	3
蔡景修等，1999^[5]	174/218	38.4	319/74	363/29	5
黄莚庭等，2000^[6]	431/424	43.9	684	未述	5
谢树民等，2002^[7]	18/64	40.65±9.85	104	105/15	5
XU Xinbao, et al，2005^[8]	229/256	40.8	273	468/40	5
黄永南等，2005^[9]	56/40	46±12	75	86/10	4.7
纪智礼等，2006^[10]	31/30	未述	未述	未述	3
金洪永等，2008^[11]	56/159	62	178	175/40	5.3
任学群等，2008^[12]	67/215	39.4±10.6	359	426	3.6

研究者，发表年份	n/n	年龄(岁)	男(例)	病因学(例)	随访时间(年)
研究者，发表年份	n/n	(±s)	(n/n)	(乙型肝炎/其他)	随访时间(年)
Farouk A, et al，1989^[3]	123/96	36±11/36±11	120/87	131/88	6.8/6.5
Borgonovo G, et al，1996^[4]	27/27	53.6±9.3/51.0±9.4	21/22	11/43	3
蔡景修等，1999^[5]	174/218	38.4	319/74	363/29	5
黄莚庭等，2000^[6]	431/424	43.9	684	未述	5
谢树民等，2002^[7]	18/64	40.65±9.85	104	105/15	5
XU Xinbao, et al，2005^[8]	229/256	40.8	273	468/40	5
黄永南等，2005^[9]	56/40	46±12	75	86/10	4.7
纪智礼等，2006^[10]	31/30	未述	未述	未述	3
金洪永等，2008^[11]	56/159	62	178	175/40	5.3
任学群等，2008^[12]	67/215	39.4±10.6	359	426	3.6

研究者，发表年份	Child分级A/B/C	手术死亡	术后再出血	肝性脑病	远期死亡
Farouk A, et al，1989^[3]	190/20/0	4(123)/3(96)	9(123)/30(96)	23(123)/7(96)	24(119)/13(93)
Borgonovo G, et al，1996^[4]	未述	未述	3(27)/9(27)	15(27)/6(27)	19(27)/12(27)
蔡景修等，1999^[5]	198/127/67	4(174)/12(218)	11(174)/44(218)	12(174)/8(218)	15(170)/18(206)
黄莚庭等，2000^[6]	237/490/129	33(431)/25(424)	37(334)/65(343)	48(334)/19(343)	47(195)/36(179)
谢树民等，2002^[7]	13/57/12	未述	3(18)/12(64)	5(18)/4(64)	未述
XU Xinbao, et al，2005^[8]	260/164/84	10(229)/15(256)	30(229)/54(256)	19(229)/10(256)	18(219)/21(241)
黄永南等，2005^[9]	19/54/23	6(56)/2(40)	3(56)/4(40)	4(56)/1(40)	9(29)/4(17)
纪智礼等，2006^[10]	41/18/2	1(31)/2(30)	1(31)/8(30)	4(31)/0(30)	1(30)/1(28)
金洪永等，2008^[11]	46/120/49	未述	6(56)/35(159)	5(56)/0(159)	未述
任学群等，2008^[12]	81/299/46	4(67)/6(215)	5(47)/29(184)	6(47)/0(184)	9(39)/16(137)

研究者，发表年份	Child分级A/B/C	手术死亡	术后再出血	肝性脑病	远期死亡
Farouk A, et al，1989^[3]	190/20/0	4(123)/3(96)	9(123)/30(96)	23(123)/7(96)	24(119)/13(93)
Borgonovo G, et al，1996^[4]	未述	未述	3(27)/9(27)	15(27)/6(27)	19(27)/12(27)
蔡景修等，1999^[5]	198/127/67	4(174)/12(218)	11(174)/44(218)	12(174)/8(218)	15(170)/18(206)
黄莚庭等，2000^[6]	237/490/129	33(431)/25(424)	37(334)/65(343)	48(334)/19(343)	47(195)/36(179)
谢树民等，2002^[7]	13/57/12	未述	3(18)/12(64)	5(18)/4(64)	未述
XU Xinbao, et al，2005^[8]	260/164/84	10(229)/15(256)	30(229)/54(256)	19(229)/10(256)	18(219)/21(241)
黄永南等，2005^[9]	19/54/23	6(56)/2(40)	3(56)/4(40)	4(56)/1(40)	9(29)/4(17)
纪智礼等，2006^[10]	41/18/2	1(31)/2(30)	1(31)/8(30)	4(31)/0(30)	1(30)/1(28)
金洪永等，2008^[11]	46/120/49	未述	6(56)/35(159)	5(56)/0(159)	未述
任学群等，2008^[12]	81/299/46	4(67)/6(215)	5(47)/29(184)	6(47)/0(184)	9(39)/16(137)

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