Evidence map›Paper›PMID 40337405›Full record

ArticleAnnals of medicine and surgery (2012)2025

Efficacy and safety of transjugular intrahepatic portosystemic shunt versus endoscopic variceal ligation for variceal rebleeding: a systematic review and meta-analysis.

Abdelaziz A Awad, Alaa Ramadan, Abdelrahman M Elettreby, Yousef Radwan Alnomani, Ahmed Hamdy Zabady, Esraa Abdelhafz, Yousef Ahmed Elamin, Mahmoud Ali, Merna R Roshdy, Omar Abdelrahim and 4 more

Abstract read
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In one paragraph

Article in Annals of medicine and surgery (2012), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Abdelaziz A AwadFaculty of Medicine, Ai-Azhar University, Cairo, Egypt.
Alaa RamadanFaculty of Medicine, South Valley University, Qena, Egypt.
Abdelrahman M ElettrebyFaculty of Medicine, Mansoura University, Mansoura, Egypt.
Yousef Radwan AlnomaniFaculty of Medicine, Benha University, Benha, Egypt.
Ahmed Hamdy ZabadyDepartment of microbiology, Faculty of Science, Damanhour University, Damanhour, Egypt.
Esraa AbdelhafzFaculty of Pharmacy, Modern University for Technology & Information, Cairo, Egypt.
Yousef Ahmed ElaminFaculty of Medicine, Lecturer, Department of General surgery, Zagazig University, Zagazig, Egypt.
Mahmoud AliFaculty of Medicine, Al-Azhar University, Damietta, Egypt.
Merna R RoshdyFaculty of Medicine, Sohag University, Sohag, Egypt.
Omar AbdelrahimTheodore Bilharz Research Institute, Giza, Egypt.
Moustafa S MohamedSednawi Hospital for Health Insurance, Cairo, Egypt.
Mohamed ElmasryFaculty of Medicine, Alexandria University, Alexandria, Egypt.
Naji Al-BawahFaculty of Medicine, Sana'a University, Sana'a, Yemen.
Mohamed FakhryDepartment of Hepatology and Gastroenterology and Infectious Diseases, Al-Azhar University, Assuit, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Variceal bleeding is a significant cause of morbidity and mortality among patients with cirrhosis. While both transjugular intrahepatic portosystemic shunt (TIPS) and endoscopic variceal ligation (EVL) are utilized for variceal rebleeding prevention, their comparative efficacy and safety remain debated. Methods: A systematic review and meta-analysis were conducted to compare TIPS with EVL for variceal rebleeding prevention. A comprehensive search of electronic databases on PubMed, Embase, Scopus, and Web of Science identified 16 studies meeting inclusion criteria. Data on outcomes including gastrointestinal bleeding, variceal rebleeding, hepatic encephalopathy, treatment failure, and mortality were extracted and analyzed. Results: TIPS was associated with significantly lower rates of gastrointestinal bleeding (RR = -0.69, 95% CI [-0.92, -0.47], Conclusion: TIPS demonstrates superiority over EVL in reducing variceal rebleeding and gastrointestinal bleeding. However, it is associated with higher rates of hepatic encephalopathy and treatment failure. Individualized treatment decisions should consider patient characteristics and treatment goals to optimize outcomes in variceal bleeding management. Further research is warranted to refine treatment strategies and minimize adverse events associated with both interventions.

Indexed as

cirrhosisendoscopic variceal ligationEVLmeta-analysisTIPStransjugular intrahepatic portosystemic shuntvariceal bleeding

Identifiers

PMID40337405
PMCPMC12055141

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.