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Transjugular Intrahepatic Portosystemic Shunts Versus Sclerotherapy: A Discussion of Discordant Results

Harold O. Conn, MD
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Yale University, New Haven, CT 06510 Note added in proof: After this editorial was typeset, a report by Rossle and colleagues of a randomized clinical trial comparing TIPS and endoscopic sclerotherapy was published in The Lancet [17]. This study is the largest of the four studies published on this topic so far. It differs from the others in that it compares TIPS plus embolization of esophageal varices with endoscopic sclerotherapy that used 1) polidocanol or 2) banding ligation of varices plus propanolol in a dose designed to reduce the heart rate by 25%. Revisions of the stent-shunts and repeated courses of sclerotherapy, the standard methods of applying these therapies, were performed as needed. In 14% of patients in the endoscopy group, TIPS were created when sclerotherapy was deemed unsuccessful. Requests for Reprints: Harold O. Conn, MD, 160 Morgan Avenue, East Haven, CT 06512.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1997;126(11):907-910. doi:10.7326/0003-4819-126-11-199706010-00010
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