Clinical study on transjugular intrahepatic portosystemic shunt in the treatment of hepatorenal syndrome

Abstract

Objective To explore the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of hepatorenal syndrome (HRS).Methods From January 2009 to December 2012,the clinical data of three type 1 HRS cases and five type 2 HRS cases received TIPS operation were collected.The volume of 24 h urine,liver and renal function,and the occurrence of complications of portal hypertension were recorded and followed-up.Wilcoxon rank sum test was performed for non-normal distributed measurement data.Results TIPS of all the patients was successful and combined with devascularization in four patients.Before operation,the serum creatinine and volume of urine was 204.0 (180.8,229.8) μmol/L and 810 (600,925) mL,seven days after operation was 160.7 (120.2,184.0) μmol/L and 1 300 (975,1 500) mL,respectively,and the differences were statistically significant (Z=-2.1 and-2.2,both P＜0.05).One month after operation,renal function of five patients recovered to normal.At the 7th day after operation,total bilirubin level of three patients increased and that of two patients decreased to the preoperative base line value at one month and three month.Mild or moderate hepatic encephalopathy occurred in three patients after operation and relieved after medicine treatment.At 6th month after operation,two of three type 1 HRS patients survived.Of five type 2 HRS patients,one received liver transplantation at 6th week after operation,three of the left four cases survived at the 6th month after operation.Conclusion After safety and efficacy were evaluated,TIPS may be one of the methods used for the treatment of HRS. Key words: Hepatorenal syndrome; Liver cirrhosis; Portosystemic shunt, transjugular intrahepatic; Prognosis