Transjugular intrahepatic portosystemic shunt is effective in patients with chronic portal vein thrombosis and variceal bleeding

作     者：Xiao-Yan Sun Guang-Chuan Wang Jing Wang Guang-Jun Huang Chun-Qing Zhang Xiao-Yan Sun;Guang-Chuan Wang;Jing Wang;Guang-Jun Huang;Chun-Qing Zhang

作者机构：Department of GastroenterologyShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021China Department of Infectious DiseasesShandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021China 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2021年第20卷第2期

页      面：128-136页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：supported by grants from Shandong Province Key Research and Development projects(2017GSF218026 and 2016GSF201001) Health and Family Planning Commission of Shandong Province(2017WS199)。 

主　　题：Chronic portal vein thrombosis Transjugular intrahepatic portosystemic shunt Variceal bleeding Hepatic encephalopathy 

摘      要：Background:Studies about treatment of patients with chronic portal vein thrombosis(CPVT)are still limited,especially in different types of CPVT.This study aimed to evaluate the effect of transjugular intrahepatic portosystemic shunt(TIPS)in all types of CPVT with variceal bleeding.Methods:Patients with CPVT who received TIPS treatment between January 2011 and June 2019 were divided into four types according to the extent of thrombosis.All patients had a history of variceal bleeding.The characteristics and clinical parameters were collected and recorded.Data on procedure success rate,variation in portal vein pressure,rebleeding,hepatic encephalopathy(HE),stent stenosis,and overall mortality were analyzed.Results:A total of 189 patients were included in this study(39 in type 1,84 in type 2,48 in type 3,18 in type 4).The TIPS procedure success rate was 86.2%.The success rate was significantly different among the four types(89.7%vs.88.1%vs.83.3%vs.77.8%,P=0.001).In the TIPS success group,portal vein pressure was significantly reduced from 27.15±6.59 to 19.74±6.73 mm Hg after the procedure(P0.001)and the rebleeding rate was significantly lower than that of the fail group(14.7%vs.30.8%,P=0.017).In addition,there were no significant differences in HE rate(30.7%vs.26.9%,P=0.912)or overall mortality(12.9%vs.19.2%,P=0.403)between the TIPS success group and the fail group.In the TIPS success group,we found that the occurrence of HE was significantly different(P=0.020)among the four types,while there were no significant differences in rebleeding rate(P=0.669),stent stenosis rate(P=0.056),or overall mortality(P=0.690).Conclusions:TIPS was safe and effective in decreasing portal vein pressure and rebleeding rate in patients with CPVT.