Follow-up study of 116 cases of transjugular intrahepatic portosystemic shunt in the treatment of cirrhotic portal hypertension

Abstract

Objective: To investigate the incidence rate of transjugular intrahepatic portosystemic shunt (TIPS) complications in the treatment of cirrhotic portal hypertension, and analyze the cause of complication to management methods. Methods: Data of 116 patients obtained from Zhongnan Hospital of Wuhan University were retrospectively analyzed. Portal venous pressure, routine blood test, coagulation test, liver and kidney function test, ammonia blood test, imaging and endoscopy reports were collected before and after procedure. The incidence rate of hepatic encephalopathy, gastrointestinal bleeding, ascites and shunt dysfunctions were observed. Data were expressed as mean ± Standard deviation and analyzed by t-test. A chi-squared test was used for comparison between categorical variables. Results: The success rate of TIPS operation was 97.41% (113/116). Two patients underwent prompt TIPS procedure due to active bleeding. Bleeding was successfully stopped. Portal venous pressure of 113 patients decreased from (42.73 ± 7.64) cmH(2)O to (24.92 ± 7.60) cmH(2)O, and the difference was statistically significant (P < 0.01). Twenty cases were of hepatic encephalopathy. Preoperative level of Child-pugh class C patients was more susceptible to hepatic encephalopathy within 3 months after procedure than class A and B. After TIPS procedure, there were 22 cases of gastrointestinal bleeding, 18 cases of shunt dysfunctions and 26 cases of disease related death. Conclusion: Rational patient selection strategies can effectively reduce portal venous pressure, incidence of hepatic encephalopathy, improve mid-and long-term therapeutic effects, and provide opportunities for liver transplantation.