Management and prognosis of spontaneous splenorenal shunt in liver cirrhosis
10.3760/cma.j.cn113855-20231012-00235
- VernacularTitle:肝硬化自发性脾肾分流的治疗与预后分析
- Author:
Wenhao XUE
1
;
Lei XIA
;
Shirui LIU
;
Yunpeng LUO
;
Baoning ZHOU
;
Jintao SHAN
;
Shichang DU
;
Yiming CHAI
;
Zhen LI
Author Information
1. 郑州大学第一附属医院腔内血管外科，郑州 450052
- Keywords:
Liver cirrhosis;
Liver transplantation;
Splenorenal shunt tract;
Intervention
- From:
Chinese Journal of General Surgery
2024;39(5):344-349
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical characteristics of patients with spontaneous splenorenal shunt (SSRS) in liver cirrhosis, and to compare the effects and prognosis of different treatments.Methods:The data of cirrhotic patients with SSRS at the First Affiliated Hospital of Zhengzhou University between 2016-2022 were retrospectively analyzed.Patients were divided into Group A receiving conservative treatment, Group B by simple embolization, Group C undergoing TIPS combined with embolization, and Group D given liver transplantation. Life status, liver function changes, incidences of adverse events, and survival between groups were compared.Results:SSRS diameter was positively correlated with blood ammonia ( R=0.478) and negatively correlated with portal vein diameter ( R=-0.301). SSRS diameter is a protective factor for gastrointestinal hemorrhage and ascites and a risk factor for hepatic encephalopathy; Blood ammonia decreased and prothrombin time prolonged after treatment in group A ( P<0.05), blood ammonia decreased and albumin increased in group B ( P<0.05). Hemoglobin and bilirubin increased in group C ( P<0.05), blood ammonia and bilirubin decreased and platelets and albumin increased in group D ( P<0.05); Survival analysis showed that the prognosis of groups A and C was related to liver function, and the survival rate of group D was the highest of all ( P<0.05). Conclusions:SSRS embolization is safe and effective, and liver transplantation improves patient survival. Individualized treatment should be selected based on patient symptoms, liver function, and shunt diameter.
