Safety and effectiveness of salvage transjugular intrahepatic portosystemic shunt for hepatocellular carcinoma with Vp4 portal vein tumor thrombus
10.3760/cma.j.cn113884-20230712-00198
- VernacularTitle:肝细胞癌伴Vp4型门静脉瘤栓患者行挽救性TIPS的安全性及有效性研究
- Author:
Qinggui JIANG
1
;
Tianshi LYU
;
Hang YAO
;
Sitong WU
;
Li SONG
;
Xiaoqiang TONG
;
Huai LI
;
Yinghua ZOU
;
Jian WANG
Author Information
1. 北京大学第一医院介入血管外科，北京 100034
- Keywords:
Carcinoma, hepatocellular;
Portal vein tumor thrombus;
Portal hypertension;
Transjugular intrahepatic portosystemic shunt
- From:
Chinese Journal of Hepatobiliary Surgery
2023;29(10):727-731
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and effectiveness of transjugular intrahepatic portosystemic shunt (TIPS) in hepatocellular carcinoma (HCC) patients with Vp4 portal vein tumor thrombus (PVTT).Methods:Data of 15 patients undergoing TIPS for HCC with Vp4 PVTT and portal hypertension (PTN) in Peking University First Hospital from July 2018 to February 2023 were retrospectively analyzed, including 14 males and 1 female, aged (61.5±11.1) years old, ranging from 40 to 78 years old. The success rate of TIPS, portal pressure gradient (PPG) before and after procedure, perioperative adverse effects and complications were recorded. The survival status of patients was followed up by telephone review after surgery. Kaplan-Meier method was used for survival analysis.Results:The procedure of TIPS was performed uneventfully in all patients, with a technical success rate of 100% (15/15). PPG before and after TIPS were (31.73±5.48) mmHg (1 mmHg=0.133 kPa) and (17.60±3.66) mmHg, respectively, and the difference was statistically significant ( P<0.001). No perioperative death, hepatic artery or bile duct injury, acute liver failure or other major complications occurred. Compared with the preoperative status, the performance status scores [0(0, 0) vs. 3(3, 3)] and Child-Pugh scores [6(5, 8) vs. 9(8, 10)] were lower in patients one month after TIPS (all P<0.05). The median survival time was 228 d. Kaplan-Meier curves showed that the cumulative survival rates at 3, 6, 12 and 24 months after TIPS were 100%, 64.3%, 32.7% and 8.2%, respectively. Conclusion:TIPS could be safe and effective for HCC with Vp4 PVTT and severe PTN.
