Variceal bleeding is one of the major complications of portal hypertension.
静脉曲张出血是门脉高压症的主要并发症之一。
Gastric variceal bleeding is less common than esophageal variceal bleeding; however, it is associated with a high morbidity and mortality rate and its management is largely uncharted due to a relatively less-established literature.
胃静脉曲张出血比食管静脉曲张出血更不常见；然而，它与高发病率和死亡率相关，由于相对较少的文献，其管理在很大程度上是未知的。
In the West (United States and Europe), the primary school of management is to decompress the portal circulation utilizing the transjugular intrahepatic portosystemic shunt (TIPS).
在西方（美国和欧洲），治疗初期是利用经颈静脉肝内门静脉系统分流(TIPS)减压门静脉循环。
In the East (Japan and South Korea), the primary school of management is to address the gastric varices (GVs) specifically by sclerosing them utilizing the balloon-occluded retrograde transvenous obliteration (BRTO) procedure.
在远东（日本和韩国），治疗初期是解决胃静脉曲张(GVs)，特别是通过使用球囊闭塞的逆行经静脉闭塞(BRTO)程序硬化它们。
The concept (1970s), evolution, and development (1980s–1990s) of both procedures run parallel to one another; neither is newer than the other is.
这两个过程的概念（70年代)、进化和发展(80年代-90年代）都是并行运行的；两者都没有比另一个更更新。
The difference is that one was adopted mostly by the East (BRTO), while the other has been adopted mostly by the West (TIPS).
不同之处在于，一个主要被东方(BRTO)采用，而另一个主要被西方(TIPS)采用。
TIPS is effective in emergently controlling bleeding for GVs even though the commonly referenced studies about managing GVs with TIPS are studies with TIPS created by bare stents.
TIPS在紧急控制GVs出血方面是有效的，尽管关于使用TIPS管理GVs的常用研究是使用裸支架创建的TIPS的研究。
However, the results have improved with the use of stent grafts for creating TIPS.
然而，随着使用支架移植物创建TIPS，结果有所改善。
Nevertheless, TIPS cannot be tolerated by patients with poor hepatic reserve.
然而，肝储备较差的患者不能耐受TIPS。
BRTO is equally effective in controlling bleeding GVs as well as significantly reducing the GV rebleed rate.
BRTO在控制出血的胃静脉曲张出血和显著降低GV再出血率方面同样有效。
But the resultant diversion of blood flow into the portal circulation, and in turn the liver, increases the risk of developing esophageal varices and ectopic varices with their potential to bleed.
但由此产生的血液流量分流到门静脉循环，进而进入肝脏，增加了发生食管静脉曲张和异位静脉曲张的风险，并有其出血的可能性。
Unlike TIPS, the blood diversion that occurs after BRTO improves, if not preserves, hepatic function for 6–9 months post-BRTO.
与TIPS不同的是，BRTO后发生的血液转移在BRTO后6-9个月内可以改善肝功能。
The authors discuss the detailed results and critique the literature, which has evaluated and remarked on both procedures.
作者讨论了详细的结果和批评了文献，并对这两种程序进行了评价和评论。
Future research prospects and speculation as to the ideal patients for each procedure are discussed.
本文讨论了未来对每种手术的理想患者的研究前景和推测。
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