Transjugular intrahepatic portosystemic shunt for the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis: study protocol for a randomised controlled trial

作者：Xingshun Qi, Chuangye He, Zhanxin Yin, Zhengyu Wang, Hongbo Zhang, Liping Yao, Jianhong Wang, Jielai Xia, Hong Cai, Zhiping Yang, Ming Bai, Wengang Guo, Jing Niu, Kaichun Wu, Daiming Fan, Guohong Han · 发表于：BMJ Open · 年份：2013 · DOI：10.1136/bmjopen-2013-003370 · 被引用次数：6 · 研究领域：Liver Disease and Transplantation、Hepatocellular Carcinoma Treatment and Prognosis、Liver Disease Diagnosis and Treatment

INTRODUCTION: Portal vein thrombosis (PVT) increases the risk of variceal rebleeding in liver cirrhosis. However, the strategy for preventing variceal rebleeding in cirrhotic patients with PVT has not been explored. This study aims to evaluate whether the transjugular intrahepatic portosystemic shunt (TIPS) or conventional therapy is preferable for the prevention of variceal rebleeding in liver cirrhosis patients with PVT. METHODS AND ANALYSIS: This is a randomised controlled trial comparing the safety and efficacy of TIPS versus conventional therapy (ie, endoscopic therapy combined with non-selective β-blockers and anticoagulants) for the prevention of variceal rebleeding in cirrhotic patients with non-tumoral PVT. A total of 50 cirrhotic patients with PVT (thrombus >50% of portal vein lumen occupancy) and a history of variceal bleeding will be stratified according to the Child-Pugh class and degree of PVT, and randomised into the TIPS and conventional therapy groups. The primary objective was to compare the incidence of variceal rebleeding between the two groups. The secondary objectives were to compare the overall mortality, variceal rebleeding-related mortality, portal vein recanalisation and complications between the two groups, and to observe the progression of PVT in patients without portal vein recanalisation. ETHICS AND DISSEMINATION: This study was approved by the ethics committee of Xijing hospital (No. 20110224-5), and was registered at ClinicalTrials.gov (NCT0132...