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PWE-157 Early Tips (transjugular Intrahepatic Portosystemic Shunt) For Acute Variceal Bleeding Complicating Alcoholic Hepatitis (ah)
  1. S Alam1,
  2. E Britton1,
  3. U Shaikh2,
  4. J Evans2,
  5. P Richardson1
  1. 1Gastroenterology, Royal Liverpool University Hospital, Liverpool, UK
  2. 2Radiology, Royal Liverpool University Hospital, Liverpool, UK

Abstract

Introduction The ideal management of variceal bleeding in the setting of acute alcoholic hepatitis is unclear. We present the outcome of this subgroup of patients in a cohort of patients treated with primary TIPS for variceal bleeding.

Methods A retrospective analysis on patients who had TIPS procedure performed as a primary treatment modality within 72 h of acute variceal bleeding from December 2010 to April 2013 with a minimum of 6 months follow up was performed.

Results 56 patients were included into the final analysis. In AH patients (n = 18) mean age was 48 years (30–65), mean discriminant function (DF) was 51 (24–87) and mean MELD score was 22. The 6 month mortality was 50%(9/18) with (7/9) dying within 30 days. The median HVPG (mmHg) pre-TIPS and post-TIPS were 16.5 and 6.5 respectively. In non-AH patient (n = 38) average age was 51y (25–70) mean MELD score was 14 (22–7). The mortality was 13% (5/38) at 6 months, (3/5) died by day 30. The median HVPG (mmHg) pre-TIPS and post-TIPS was 23 and 10 respectively.

Conclusion In patients with variceal bleeding complicating AH there is a higher 30 day and 6 month mortality in patients managed with a primary TIPS in comparison to patients with cirrhosis. The ideal management of this complex group remains unclear.

Disclosure of Interest None Declared.

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