caa a22 4500 445887737 CHVBK 20180317145604.0 cr unu---uuuuu 170323e20110101xx s 000 0 eng 10.1007/s00535-010-0282-9 doi (NATIONALLICENCE)springer-10.1007/s00535-010-0282-9 Transjugular intrahepatic portosystemic shunt versus paracentesis plus albumin in patients with refractory ascites who have good hepatic and renal function: a prospective randomized trial [Elektronische Daten] [Yoshiyuki Narahara, Hidenori Kanazawa, Takeshi Fukuda, Yoko Matsushita, Hirotomo Harimoto, Hideko Kidokoro, Tamaki Katakura, Masanori Atsukawa, Yasuhiko Taki, Yuu Kimura, Katsuhisa Nakatsuka, Choitsu Sakamoto] Background: Transjugular intrahepatic portosystemic shunt (TIPS) has recently been reported to be effective in the treatment of cirrhotic patients with refractory ascites. However, the clinical utility of TIPS in the subset of refractory ascitic patients with good hepatic and renal function is uncertain. The aim of this study was to compare the efficacy of TIPS to that of large-volume paracentesis in cirrhotic patients with refractory ascites who have good hepatic and renal function. Methods: Sixty cirrhotic patients with refractory ascites who presented with a Child-Pugh score of <11, serum bilirubin of <3mg/dl and creatinine of <1.9mg/dl were assigned randomly to TIPS (n=30) or large-volume paracentesis plus albumin (n=30). The primary endpoint was survival. The secondary endpoints were response to treatment and development of hepatic encephalopathy. Results: The baseline characteristics were similar in the two groups. Seventeen patients treated with TIPS and 21 treated with paracentesis died during the study period. The cumulative probabilities of survival at 1 and 2years were 80 and 64% in the TIPS group and 49 and 35% in the paracentesis group (p<0.005). TIPS was significantly superior to paracentesis in the control of ascites (p<0.005). Treatment failure was more frequent in the paracentesis group, whereas the frequency of hepatic encephalopathy was greater in the TIPS group. Conclusions: In cirrhotic patients with refractory ascites who have good hepatic and renal function, TIPS improves survival and provides better control of ascites than large-volume paracentesis. Springer, 2010 Transjugular intrahepatic portosystemic shunt nationallicence Large-volume paracentesis nationallicence Refractory ascites nationallicence Hepatic encephalopathy nationallicence Narahara Yoshiyuki Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut Kanazawa Hidenori Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut Fukuda Takeshi Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut Matsushita Yoko Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut Harimoto Hirotomo Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut Kidokoro Hideko Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut Katakura Tamaki Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut Atsukawa Masanori Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut Taki Yasuhiko Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut Kimura Yuu Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut Nakatsuka Katsuhisa Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut Sakamoto Choitsu Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut Journal of Gastroenterology Springer Japan 46/1(2011-01-01), 78-85 0944-1174 46:1<78 2011 46 535 https://doi.org/10.1007/s00535-010-0282-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00535-010-0282-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Narahara Yoshiyuki Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut NATIONALLICENCE 700 1- Kanazawa Hidenori Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut NATIONALLICENCE 700 1- Fukuda Takeshi Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut NATIONALLICENCE 700 1- Matsushita Yoko Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut NATIONALLICENCE 700 1- Harimoto Hirotomo Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut NATIONALLICENCE 700 1- Kidokoro Hideko Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut NATIONALLICENCE 700 1- Katakura Tamaki Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut NATIONALLICENCE 700 1- Atsukawa Masanori Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut NATIONALLICENCE 700 1- Taki Yasuhiko Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut NATIONALLICENCE 700 1- Kimura Yuu Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut NATIONALLICENCE 700 1- Nakatsuka Katsuhisa Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut NATIONALLICENCE 700 1- Sakamoto Choitsu Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan aut NATIONALLICENCE 773 0- Journal of Gastroenterology Springer Japan 46/1(2011-01-01), 78-85 0944-1174 46:1<78 2011 46 535 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer