The Treatment of Hepatocirrhosis and Portal Hypertension
Condition: Hepatic Cirrhosis; Portal Hypertension
MeSH terms: Liver Cirrhosis; Hypertension, Portal; Hypertension; Fibrosis
Study type: Interventional

Summary: 
      This study compare the efficiency of partial splenic embolization +endoscopical therapy with
      endoscopical therapy alone in gastroesophageal variceal haemorrhage accompanied with
      splenomegaly or hypersplenism of hepatocirrhosis and portal hypertension treatment.
    

Detailed description: 
      Endoscopic therapy is the mature treatment of gastroesophageal variceal haemorrhage and PSE
      is an effective method for treatment of the hypersplenism and portal hypertension. Existing
      researches show that endoscopic therapy + PSE is more effective than endoscopic therapy alone
      in prevention of esophageal varices bleeding recurrence in the patients with liver cirrhosis.
      However, there is few articles which proved long-term effectiveness of endoscopic therapy +
      PSE, it needs further research on this issue. This study compares the efficiency of partial
      splenic embolization +endoscopic therapy with endoscopic therapy alone in the treatment of
      gastroesophageal variceal haemorrhage accompanied with splenomegaly or hypersplenism in the
      patients with hepatocirrhosis and portal hypertension.
    

Intervention name(s): Endoscopic therapy+ beta blockers; Endoscopic therapy+ PSE+beta blockers; beta blockers; Endoscopic therapy; Endoscopic therapy+ PSE; Somatostatin+Endoscopic therapy; Somatostatin+Endoscopic therapy+PSE
Intervention type(s): Procedure; Procedure; Procedure; Procedure; Procedure; Procedure; Procedure
Intervention description(s): Endoscopic variceal ligation (EVL) is for the secondary prophylaxis of esophageal variceal hemorrhage,and Cyanoacrylate injection is for gastric varices (GV).A standard dose of NSBB (propranolol) was applied to patients according to the Baveno VI recommendations if there were no contraindications.; Endoscopic variceal ligation (EVL) is for the secondary prophylaxis of esophageal variceal hemorrhage,and Cyanoacrylate injection is for gastric varices (GV).A standard dose of NSBB (propranolol) was applied to patients according to the Baveno VI recommendations if there were no contraindications.Partial splenic embolization (PSE) is one of the intra-arterial therapeutic approaches to embolize 60-80% splenic blood flow.; A standard dose of NSBB (propranolol) was applied to the primary prevention patients according to the Baveno VI recommendations if there were no contraindications.; Endoscopic variceal ligation (EVL) is for the primary prophylaxis of esophageal variceal hemorrhage,and Cyanoacrylate injection is for gastric varices (GV).; Endoscopic variceal ligation (EVL) is for the primary prophylaxis of esophageal variceal hemorrhage,and Cyanoacrylate injection is for gastric varices (GV).Partial splenic embolization (PSE) is one of the intra-arterial therapeutic approaches to embolize 60-80% splenic blood flow.; The first dose of 250 was injected intravenously, followed by a continuous iv infusion of 250 for 3-5 days. Endoscopic variceal ligation (EVL) is for the acute bleeding of esophageal variceal hemorrhage,and Cyanoacrylate injection is for gastric varices (GV).; The first dose of 250 was injected intravenously, followed by a continuous iv infusion of 250 for 3-5 days. Endoscopic variceal ligation (EVL) is for the acute bleeding of esophageal variceal hemorrhage,and Cyanoacrylate injection is for gastric varices (GV).Partial splenic embolization (PSE) is one of the intra-arterial therapeutic approaches to embolize 60-80% splenic blood flow.
Intervention MeSH terms: Adrenergic beta-Antagonists; Somatostatin
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Partial splenic embolization; Hypersplenism; Thrombocytopenia; Portal hypertension; Gastroesophageal varices; Secondary prophylaxis; Endoscopic variceal ligation; Non-selective beta-blocker