Brief Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 28, 2013; 19(44): 8085-8092
Published online Nov 28, 2013. doi: 10.3748/wjg.v19.i44.8085
Clinical effects and complications of TIPS for portal hypertension due to cirrhosis: A single center
Jian-Ping Qin, Ming-De Jiang, Wen Tang, Xiao-Ling Wu, Xin Yao, Wei-Zheng Zeng, Hui Xu, Qian-Wen He, Ming Gu
Jian-Ping Qin, Ming-De Jiang, Wen Tang, Xiao-Ling Wu, Xin Yao, Wei-Zheng Zeng, Hui Xu, Department of Digestion, Chengdu Military General Hospital, Chengdu 610083, Sichuan Province, China
Qian-Wen He, Ming Gu, Department of Radiology, Chengdu Military General Hospital, Chengdu 610083, Sichuan Province, China
Author contributions: Qin JP, Jiang MD, Tang W and Xu H designed and implemented the study and wrote the manuscript; Wu XL, Zeng WZ, Yao X, He QW and Gu M collected data and wrote the manuscript; Tang W wrote the manuscript and did statistical analysis.
Supported by The grant from Chengdu Military General Hospital, No. 424121HK
Correspondence to: Hui Xu, MD, Department of Digestion, Chengdu Military General Hospital, No. 270 Tian Hui Road, Jinniu District, Chengdu 610083, Sichuan Province, China. xuhuiyy163@163.com
Telephone: +86-28-86570307 Fax: +86-28-86571041
Received: May 7, 2013
Revised: June 28, 2013
Accepted: July 30, 2013
Published online: November 28, 2013
Abstract

AIM: To determine the clinical effects and complications of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension due to cirrhosis.

METHODS: Two hundred and eighty patients with portal hypertension due to cirrhosis who underwent TIPS were retrospectively evaluated. Portal trunk pressure was measured before and after surgery. The changes in hemodynamics and the condition of the stent were assessed by ultrasound and the esophageal and fundic veins observed endoscopically.

RESULTS: The success rate of TIPS was 99.3%. The portal trunk pressure was 26.8 ± 3.6 cmH2O after surgery and 46.5 ± 3.4 cmH2O before surgery (P < 0.01). The velocity of blood flow in the portal vein increased. The internal diameters of the portal and splenic veins were reduced. The short-term hemostasis rate was 100%. Esophageal varices disappeared completely in 68% of patients and were obviously reduced in 32%. Varices of the stomach fundus disappeared completely in 80% and were obviously reduced in 20% of patients. Ascites disappeared in 62%, were markedly reduced in 24%, but were still apparent in 14% of patients. The total effective rate of ascites reduction was 86%. Hydrothorax completely disappeared in 100% of patients. The incidence of post-operative stent stenosis was 24% at 12 mo and 34% at 24 mo. The incidence of post-operative hepatic encephalopathy was 12% at 3 mo, 17% at 6 mo and 19% at 12 mo. The incidence of post-operative recurrent hemorrhage was 9% at 12 mo, 19% at 24 mo and 35% at 36 mo. The cumulative survival rate was 86% at 12 mo, 81% at 24 mo, 75% at 36 mo, 57% at 48 mo and 45% at 60 mo.

CONCLUSION: TIPS can effectively lower portal hypertension due to cirrhosis. It is significantly effective for hemorrhage of the digestive tract due to rupture of esophageal and fundic veins and for ascites and hydrothorax caused by portal hypertension.

Keywords: Transjugular intrahepatic portosystemic shunt, Cirrhosis, Portal hypertension, Therapeutic effect, Complication

Core tip: This study identified the clinical effects and complications of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension due to cirrhosis in 280 patients who underwent this procedure at our centre between January 2005 and December 2009. TIPS can effectively lower portal hypertension due to cirrhosis. It is significantly effective for hemorrhage of the digestive tract due to rupture of esophageal and fundic veins and for ascites and hydrothorax caused by portal hypertension.