Efficacy and safety of surgery-assisted transjugular intrahepatic portosystemic shunt in treatment of portal hypertension comorbid with complex portal vein thrombosis

Zhenhua FAN; Chengbin DONG; Qimei LI; Yu ZHANG; Yifan WU; Dongfang LIU; Guangzhong XU; Dezhong WANG; Jianfei CHEN; Zhendong YUE; Lei WANG

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Efficacy and safety of surgery-assisted transjugular intrahepatic portosystemic shunt in treatment of portal hypertension comorbid with complex portal vein thrombosis

VernacularTitle:外科辅助经颈静脉肝内门体分流术治疗门静脉高压合并复杂门静脉血栓的效果及安全性分析
Author: Zhenhua FAN ¹ ; Chengbin DONG ¹ ; Qimei LI ¹ ; Yu ZHANG ¹ ; Yifan WU ¹ ; Dongfang LIU ¹ ; Guangzhong XU ² ; Dezhong WANG ² ; Jianfei CHEN ² ; Zhendong YUE ¹ ; Lei WANG ¹
Author Information

1. Department of Interventional Therapy， Beijing Shijitan Hospital， Capital Medical University， Beijing 100038， China
2. Minimally Invasive Diagnosis and Treatment Center for Liver Diseases， Beijing Shijitan Hospital， Capital Medical University， Beijing 100038， China
Publication Type:Journal Article
Keywords: Hypertension， Portal; Portal Vein Thrombosis; Portasystemic Shunt， Transjugular Intrahepatic; Surgical Procedures， Operative
From: Journal of Clinical Hepatology 2026;42(3):586-592
CountryChina
Language:Chinese
Abstract: ObjectiveTo investigate the feasibility， safety， and efficacy of surgery-assisted transjugular intrahepatic portosystemic shunt （SA-TIPS） in the treatment of portal hypertension comorbid with complex portal vein thrombosis， including cavernous transformation of the portal vein （CTPV）. MethodsAn analysis was performed for the data of 36 patients with portal hypertension and complex portal vein thrombosis who underwent SA-TIPS in Beijing Shijitan Hospital， Capital Medical University， from November 2023 to January 2025， including general status， technical data of the surgical process （surgical success rate， puncture times， time of operation， the number of stents used， and the length of shunt）， perioperative complications， and surgical recovery. The change in portal pressure gradient （PPG） after shunt was compared， and the rate of reaching the standard for PPG reduction was calculated， as well as stent patency rate within 1 week after surgery. The paired samples t-test was used for comparison of continuous data between two groups. ResultsAmong the 36 patients， 34 （94.4%） underwent SA-TIPS successfully. The incidence rate of perioperative complications was 16.7% （6/36）， including 3 cases of thoraco-abdominal hemorrhage， 2 cases of intraoperative arrhythmia， and 1 case of incision infection. There was a significant reduction in PPG after SA-TIPS （t=19.85， P<0.01）， and the patients achieving a ≥50% reduction in PPG accounted for 76.5% （26/34）. Imaging reexamination within 1 week showed a shunt patency rate of 100%. ConclusionSA-TIPS has a high technical success rate， a favorable safety profile， and good efficacy in the treatment of portal hypertension comorbid with complex portal vein thrombosis （including CTPV）， and therefore， it holds promise for clinical application.