Clinical Research
Copyright ©2006 Baishideng Publishing Group Co.
World J Gastroenterol. Oct 21, 2006; 12(39): 6331-6338
Published online Oct 21, 2006. doi: 10.3748/wjg.v12.i39.6331
Table 1 Characteristics of patients enrolled in the RCT
CharacteristicDSRS (n = 40)ES (n = 40)P
Age (yr)49.4 ± 9.953.8 ± 8.40.027
Sex: M/F27/1333/70.121
Etiology: alcoholic/ non alcoholic14/2626/140.0073
Child’s class: A/B19/2111/290.053
Prothrombin time: > 80/80-50/< 505%/82%/13%13%/62%/25%0.058
Bilirubin (μmol/L): < 20.5/20.5-51.3/> 51.362%/38%/0%41%/46%/13%0.0269
Albumin (g/L): > 30/30-25/< 2595%/5%/0%83%/17%/0%0.077
Portal perfusion: degree I/II/III45%/45%/10%42%/27%/31%0.09
Previous bleeding (n)2.3 ± 1.51.6 ± 0.090.022
Blood unit (n)5.5 ± 54.3 ± 4.20.25
Interval between bleeding and treatments (mo)3.5 ± 2.52.8 ± 3.20.32
Previous encephalopathy episodes (n)1070.41
Easily controlled preoperative ascites5110.09
Table 2 Comparison of the results of TMT, cancelling A's test and EEG. A’s test refers to the number of A's the patients has omitted to cancel in the test
PreoperativeLong-term follow-upP
TMT (s)
DSRS55.3 ± 24.955.4 ± 27.9NS
ES60.1 ± 19.766.1 ± 40.1NS
A's test
DSRS4.9 ± 3.82.6 ± 2.5< 0.05
ES5.5 ± 4.33.7 ± 3.4< 0.05
EEG (% abnormal)
DSRS20%36%< 0.05
ES16%21%NS
Table 3 Causes of death of patients submitted to DSRS (n = 26) or ES (n = 31)
Causes of deathDSRSES
Digestive bleeding1 (4%)5 (16%)
Liver failure6 (23%)11 (36%)
Hepatocellular carcinoma13 (50%)10 (32%)
Other causes6 (23%)5 (16%)
Table 4 Results (actuarial survival curves and log-rank test) of the univariate analysis of some variables calculated during different interval of follow-up
VariablesP (at 5 yr)P (at 10 yr)P (total follow-up)
Type of treatment (DSRS vs ES)0.03850.14150.1168
Sex0.21860.33740.1943
Child’s score (A vs B)0.03580.25330.1594
Etiology of cirrhosis (non-alcohol vs alcohol)0.28910.07490.0438
Portal perfusion0.26710.35790.3158
Preop. Ascites0.33390.90220.9254
Preop. encephalopathy0.65440.98570.8732
Preop. Varices0.65130.45520.3858
No. of previous bleeding0.17240.27390.1308
Preop. Bilirubin0.29440.33580.0604
Preop. GOT0.45040.26590.2553
Preop. Prothrombin time0.28350.56290.4815
Preop. Albumin0.74400.21330.1823
Age (< 53 yr)0.14190.04310.0438
Postop. Rebleeding0.17150.11680.0819
Table 5 2-yr survival and rebleeding rate in randomized controlled trials comparing DSRS with ES
Warren[5]Terés[7]Rikkers[6]Our data
2-yr survival rate
after DSRS59%a71%65%95%
2-yr survival rate
after ES84%a68%61%85%
Child's C patients43%033%0
Interval between bleeding
and treatment (d)> 3-510-15NR901
Rebleeding rate after
DSRS3%a14%a19%a2.5%a
Rebleeding rate after
ES53%a37%a57%a35%a
Variceal eradication
rateNR46%63%90%
Failure to salvage
rebleeders17%33%47%14%
Shunt for ES failure31%6%7%5%
Global mortality rate
due to rebleeding3%14%27%16%
Global mortality rate
due to other causes13%16%13%17%