Management of failures of first line treatments. - Archive ouverte HAL Access content directly
Journal Articles Digestive and Liver Disease Year : 2008

Management of failures of first line treatments.

(1) , (1)
1

Abstract

Up to 70% of the patients treated to prevent rebleeding will experience a bleeding episode within 2 years. The response should be adapted to the delay after the index bleed, the source and the severity of the haemorrhage, the underlying liver disease and the initial treatment to prevent rebleeding. Bleeding can be caused by endoscopic techniques themselves, which should incitate to complete obliteration rather than to switch to another therapy. Failure of drug therapy can be secondary to ineffectiveness, to a lack of compliance, or to an insufficient dosage. The two latter conditions may be corrected. Whenever a patient rebleeds in spite of optimal treatment, liver transplantation should be considered. When such a procedure is contra-indicated and in patients on the waiting list, a Transjugular intra-hepatic porto-systemic shunt (TIPS) should be performed.

Dates and versions

inserm-00408885 , version 1 (04-08-2009)

Identifiers

Cite

Christophe Bureau, Jean-Pierre Vinel. Management of failures of first line treatments.. Digestive and Liver Disease, 2008, 40 (5), pp.343-7. ⟨10.1016/j.dld.2008.02.014⟩. ⟨inserm-00408885⟩
15 View
0 Download

Altmetric

Share

Gmail Facebook Twitter LinkedIn More