Clinical efficacy of transjugular intrahepatic portosystemic shunt for gastrointestinal hemorrhage in patients with idiopathic noncirrhotic portal hypertension
10.3760/cma.j.cn112138-20210902-00608
- VernacularTitle:经颈静脉肝内门体分流术治疗特发性非肝硬化门静脉高压消化道大出血的临床疗效
- Author:
Wenguang ZHANG
1
;
Jianzhuang REN
;
Tao WEI
;
Yaopu WANG
;
Jinfeng XUE
;
Pengfei CHEN
;
Xueliang ZHOU
;
Xinwei HAN
Author Information
1. 郑州大学第一附属医院介入科，郑州 450052
- Keywords:
Idiopathic non-cirrhotic portal hypertension;
Gastrointestinal hemorrhage;
Portosystemic shunt, transjugular intrahepatic
- From:
Chinese Journal of Internal Medicine
2022;61(5):548-551
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the medium-long term efficacy of transjugular intrahepatic portosystemic shunt (TIPS) for gastrointestinal hemorrhage in patients with idiopathic non-cirrhotic portal hypertension (INCPH).Methods:From March 2013 to July 2018, clinical data of 13 INCPH patients, including 5 males, 8 females,with gastrointestinal hemorrhage were retrospectively analyzed, who were diagnosed at the First Affiliated Hospital of Zhengzhou University, Anyang Fifth People′ s Hospital and Yuncheng Central Hospital. All patients received TIPS treatment. The general information, postoperative survival rate, the incidence of rebleeding, shunt dysfunction rate, and incidence of hepatic encephalopathy were analyzed.Results:All 13 patients with INCPH completed TIPS successfully with an average age of 45±8 (33 to 59) years. The hepatic venous pressure gradient (HVPG) decreased from 20.0-26.0 (22.6±1.9) mmHg before procedure to 8.0-14.0 (9.4±3.2) mmHg after. The median follow-up time was 44±7 (31 to 53) months. One patient died of liver failure 27 months after TIPS. Hepatic encephalopathy occurred cumulatively in 1 case (1/13), 1 case (1/13) and 1 case (1/13) in 12, 24 and 36 months after TIPS. Stent restenosis occurred cumulatively in 2 cases (2/13), 3 cases (3/13) and 3 cases (3/13) in 12, 24 and 36 months after TIPS. Portal vein thrombosis occurred cumulatively in 2 cases (2/13), and no primary liver cancer developed.Conclusions:TIPS is safe and effective in the treatment of INCPH with gastrointestinal bleeding with favorable medium-long term outcome.
