Analysis of the correlation between splenic changes and hepatic encephalopathy after transjugular intrahepatic portosystemic shunt
10.12025/j.issn.1008-6358.2025.20251325
- VernacularTitle:经颈静脉肝内门腔分流术后脾脏变化与肝性脑病的相关性分析
- Author:
Jun’an LIN
1
;
Jingqin MA
1
;
Rufeng CHEN
1
;
Zhiping YAN
1
Author Information
1. Department of Interventional Therapy, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai Institution of Medical Imaging, Shanghai 200032, China.
- Publication Type:Originalarticle
- Keywords:
transjugular intrahepatic portosystemic shunt;
hepatic encephalopathy;
spleen;
portal venous system;
hemodynamics
- From:
Chinese Journal of Clinical Medicine
2026;33(1):45-51
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the correlation between changes in spleen volume and stiffness before and after transjugular intrahepatic portosystemic shunt (TIPS) and the occurrence of hepatic encephalopathy. Methods A retrospective study was conducted on 104 patients who underwent TIPS in the Department of Interventional Therapy, Zhongshan Hospital, Fudan University, from January 1, 2023 to July 30, 2024. Spleen volume and stiffness were measured before and after surgery. Patients were divided into the overt hepatic encephalopathy (OHE) group and the non-OHE group. Univariate and multivariate logistic regression analyses were used to identify factors correlated with OHE after TIPS. The predictive values of the related factors of OHE were evaluated using receiver operating characteristic (ROC) curves. Results OHE occurred in 34 patients (32.69%). Compared with the non-OHE group, the OHE group had a smaller percentage reduction in spleen volume after TIPS (P＜0.001), but there was no statistically significant difference in the percentage reduction in spleen stiffness between the two groups. Multivariate logistic regression analysis revealed that the percentage reduction in spleen volume was correlated with postoperative OHE (OR＝0.90, P＜0.001). ROC analysis showed that the area under the curve (AUC) for spleen volume reduction percentage in predicting postoperative OHE was 0.773, superior to spontaneous portosystemic shunt (SPSS; Z＝2.088, P＝0.037). Conclusions Reduction in spleen volume after TIPS may be a protective factor against hepatic encephalopathy, while changes in spleen stiffness were not found to be correlated with its occurrence.
