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Titre du document / Document title

Effect of transjugular intrahepatic portosystemic shunt on quality of life

Auteur(s) / Author(s)

NAZARIAN G. K. (1) ; FERRAL H. (1) ; BJARNASON H. (1) ; CASTANEDA-ZUNIGA W. R. (1) ; RANK J. M. (2) ; BERNADAS C. A. (1) ; HUNTER D. W. (1) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Department of Radiology, the University of Minnesota Hospital and Clinic, 420 Delaware St., S.E., Box 292 UMHC, Minneapolis, MN 55455-0392, ETATS-UNIS
(2) Department of Medicine, the University of Minnesota Hospital and Clinic, 420 Delaware St., S.E., Box 36 UMHC, Minneapolis, MN 55455-0392, ETATS-UNIS

Résumé / Abstract

OBJECTIVE. The objective of this study was to determine the effect of the transjugular intrahepatic portosystemic shunt (TIPS) procedure on the quality of life. SUBJECTS AND METHODS. Data were collected on 99 patients who underwent the TIPS procedure between September 1991 and September 1995. Quality of life was assessed by the Karnofsky scale before and at intervals after the procedure. Procedure-related complications and other aspects of the patients' overall well-being, as reflected in liver and kidney function and nutritional status, were reviewed immediately before and after TIPS creation. Finally, mortality and TIPS patency rates were tabulated. RESULTS. We observed significantly improved quality of life. The quality of life remained significantly improved throughout the 24-month follow-up period. During the 1- to 3-month interval after the TIPS procedure, we observed in patients a significant decrease in blood urea nitrogen and an increase in albumin and bilirubin. During this period, patients had no significant change in liver enzymes, prothrombin time, ammonia, or creatinine. Complications of the TIPS procedure included a 30% incidence of new or worsened encephalopathy and a 15% incidence of other severe complications (intraperitoneal hemorrhage, severe accelerated liver failure). The procedure-related death rate was 5%. Longer term follow-up showed an overall sustained decrease in blood urea nitrogen, an increase in albumin, and a return of bilirubin to the pre-TIPS levels or below. CONCLUSION. For patients who survive longer than I month, TIPS results in an overall, sustained improvement in the quality of life. Improved quality of life may result from a low incidence of repeat variceal bleeding, decreased ascites, and improved nutritional status.

Revue / Journal Title

American journal of roentgenology    ISSN  0361-803X   CODEN AAJRDX 

Source / Source

1996, vol. 167, no4, pp. 963-969 (20 ref.)

Langue / Language

Anglais

Editeur / Publisher

American Roentgen Ray Society, Reston, VA, ETATS-UNIS  (1976) (Revue)

Mots-clés anglais / English Keywords

Varix

;

Esophagus

;

Ascites

;

Portal hypertension

;

Bypass

;

Portocaval

;

Intrahepatic

;

Treatment

;

Quality of life

;

Human

;

Digestive diseases

;

Esophageal disease

;

Portal circulation disease

;

Cardiovascular disease

;

Vascular disease

;

Venous disease

;

Abdominal disease

;

Effusion

;

Surgery

;

Mots-clés français / French Keywords

Varice

;

Oesophage

;

Ascite

;

Hypertension portale

;

Dérivation

;

Portocave

;

Intrahépatique

;

Traitement

;

Qualité vie

;

Homme

;

Appareil digestif pathologie

;

Oesophage pathologie

;

Circulation portale pathologie

;

Appareil circulatoire pathologie

;

Vaisseau sanguin pathologie

;

Veine pathologie

;

Abdomen pathologie

;

Epanchement

;

Chirurgie

;

Mots-clés espagnols / Spanish Keywords

Varices

;

Esófago

;

Ascitis

;

Hipertensión portal

;

Derivación

;

Portocava

;

Intrahepático

;

Tratamiento

;

Calidad vida

;

Hombre

;

Aparato digestivo patología

;

Esófago patología

;

Circulación portal patología

;

Aparato circulatorio patología

;

Vaso sanguíneo patología

;

Vena patología

;

Abdomen patología

;

Derrame

;

Cirugía

;

Localisation / Location

INIST-CNRS, Cote INIST : 5093, 35400006634571.0300

Nº notice refdoc (ud4) : 3232224



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