Comparison of effects of devascularization versus shunt on patients with portal hypertension: a meta-analysis

Hepatogastroenterology. 2015 Jan-Feb;62(137):144-50.

Abstract

Background/aims: To systematically evaluate the effectiveness of devascularization and shunt on patients with portal hypertension.

Methodology: Relevant studies compared devascularization and shunt for the treatment of portal hypertension were identified searching the PubMed, Embase, Elsevier, CNKI (China National Knowledge Infrastructure) database and Cochrane Trial Register searches until December 2013. Data of interest for devascularization and shunt including postoperative recurrent bleeding, postoperative hepatic encephalopathy, ascites, operative mortality rate, and long term survival rate were subjected to meta-analysis.

Results: Eleven studies were included in the study, the results of the meta-analysis showed that all eleven clinical studies demonstrated a significantly higher postoperative recurrent bleeding rate with devascularization group than with shunt group, the rate of hepatic encephalopathy in the devascularization group was significantly lower compared with the shunt group.

Conclusion: Devascularization and shunt have different advantages and disadvantages respectively which reflected in postoperative complications and long term survival rate.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adult
  • Chi-Square Distribution
  • Esophageal and Gastric Varices / etiology
  • Esophageal and Gastric Varices / mortality
  • Esophageal and Gastric Varices / prevention & control
  • Gastrointestinal Hemorrhage / etiology
  • Gastrointestinal Hemorrhage / mortality
  • Gastrointestinal Hemorrhage / prevention & control
  • Hepatic Encephalopathy / etiology
  • Hepatic Encephalopathy / mortality
  • Hepatic Encephalopathy / prevention & control
  • Humans
  • Hypertension, Portal / complications
  • Hypertension, Portal / diagnosis
  • Hypertension, Portal / mortality
  • Hypertension, Portal / physiopathology
  • Hypertension, Portal / surgery*
  • Male
  • Middle Aged
  • Odds Ratio
  • Portal Vein / physiopathology
  • Portal Vein / surgery*
  • Portasystemic Shunt, Transjugular Intrahepatic* / adverse effects
  • Portasystemic Shunt, Transjugular Intrahepatic* / mortality
  • Recurrence
  • Risk Factors
  • Survival Analysis
  • Treatment Outcome
  • Young Adult