JOURNAL OF CLINICAL SURGERY ›› 2019, Vol. 27 ›› Issue (1): 62-66.doi: 10.3969/j.issn.1005-6483.2019.01.018

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Comparison and analysis of surgery parts in different guidelines of upper gastrointestinal bleeding with portal hypertension

  

  1. General Surgery,PLA 302 Hospital,Beijing 100039,China
  • Online:2019-01-20 Published:2019-01-20

Abstract: Objective There are many differences in the surgical contents of guidelines or consensuses for upper gastrointestinal bleeding in patients with portal hypertension.Comparing and analyzing the causes can promote understanding and recognizing.Methods Seven high-profile guidelines were selected by searching:Baveno Ⅵ consensus,AASLD guidance,UK guideline,Austrian consensus,Brazil consensus,Chinese guideline from Liver Diseases/Digestive Disease/Endoscopy Branch of Medical Association(abbr.Chinese hepatopathy guideline)and Chinese surgery guidelines from Portal Hypertension Group of Surgery Branch,Medical Association(abbr.Chinese surgery guideline).Surgery parts in contents were selected to analyze by comparing the participants and tracing the relevant references after intensive reading the documents.Besides,different editions of Baveno consensus were compared and analyzed.Results In different guidelines:AASLD,Austrian,Brazil and Chinese hepatopathy guideline enrolled 1 surgery professionals respectively;The ratio of referenced surgery articles in Baveno VI,AASLD,Austrian,Brazil,Chinese hepatopathy guideline and Chinese surgery guideline,is 0,1.4%、5.7%、3.2%、6.1%、6.7%、25.0%,respectively.The surgery parts of the Baveno consensus,showed that shunts and devascularizations are the appropriate means when endoscopic therapy failed on hemostatic treatment in Ⅰ,Ⅱ edition,only shunts are recommended in Ⅲ,Ⅳ,Ⅴ edition,and none surgery approaches recommended except extrahepatic vessel disease in Ⅵ edition.Conclusion The rapid progress of drugs,the advanced skills of endoscopy and Transjugular intrahepatic portosystemic shunt( abbr.TIPS),the lack of surgery professionals involved,and the lack of citing surgery articles,were one of the reasons for lacking voices of surgery in leading guidelines.The UK Guideline is relatively comprehensive and objective.Doctors is the final decisionmaker on the application to practice of guidelines and consensuses.

Key words: portal hypertension, guidelines and consensus, surgry, references, comparison and analysis

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