Case Control Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 21, 2025; 31(27): 108483
Published online Jul 21, 2025. doi: 10.3748/wjg.v31.i27.108483
Clinical efficacy of surgically assisted transjugular intrahepatic portosystemic shunt for cavernous transformation of portal vein
Yi-Fan Wu, Zhen-Dong Yue, Zhen-Hua Fan, Cheng-Bin Dong, Yu Zhang, Qi-Mei Li, Dong-Fang Liu, Guang-Zhong Xu, De-Zhong Wang, Hai-Ming Zhao, Zhi-Ping Wu, Lei Wang
Yi-Fan Wu, Zhen-Dong Yue, Zhen-Hua Fan, Cheng-Bin Dong, Yu Zhang, Qi-Mei Li, Dong-Fang Liu, Lei Wang, Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Guang-Zhong Xu, De-Zhong Wang, Center for Obesity and Metabolic Disease, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Hai-Ming Zhao, Department of Minimally Invasive Intervention, Xilin Gol League Central Hospital, Xilin Gol League 026000, Inner Mongolia Autonomous Region, China
Zhi-Ping Wu, Department of Gastroenterology, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
Author contributions: Wu YF designed the research study, collected the data and wrote the paper; Yue ZD, Fan ZH, Dong CB, Zhang Y, Li QM, Liu DF, Xu GZ, Wang DZ, Zhao HM and Wu ZP performed the research; Wang L designed the research, collected the data, performed the research and revised the paper.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Beijing Shijitan Hospital Affiliated to Capital Medical University Institutional Review Board, Approval No. XJS-2024-0042-002.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: Participants gave informed consent for data sharing from the Corresponding author by request at wanglei2585@bjsjth.cn.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lei Wang, Chief Physician, Department of Interventional Radiology, Beijing Shijitan Hospital, Capital Medical University, No. 10 Yangfang Dian Tieyi Road, Haidian District, Beijing 100038, China. wanglei2585@bjsjth.cn
Received: April 18, 2025
Revised: May 10, 2025
Accepted: July 1, 2025
Published online: July 21, 2025
Processing time: 94 Days and 1.4 Hours
Abstract
BACKGROUND

Transjugular intrahepatic portosystemic shunt (TIPS) is contraindicated for patients with cavernous transformation of the portal vein (CTPV) due to high surgery-related mortality risk. However, surgically assisted TIPS (SATIPS) can significantly reduce the risk.

AIM

To evaluate the clinical efficacy of SATIPS, this study was conducted.

METHODS

One hundred and seven patients with CTPV and esophagogastric variceal bleeding were recruited from January 2023 to December 2024.The patients were recruited from three different hospitals. Overall, 54 patients received SATIPS treatment (SATIPS group), while 53 patients did not receive SATIPS and underwent prophylactic endoscopic sclerosing ligation (control group). Subsequently, survival rates, incidence rates of gastrointestinal bleeding, incidence of hepatic encephalopathy rate, and the incidence of liver failure after treatment in both groups at 3 and 6 months were observed.

RESULTS

The survival rates for the SATIPS and control groups were 94.4% and 92.5% at 3 months (P value = 0.72) and 94.4% and 73.6% at 6 months (P value = 0.0051) respectively. The incidence of liver failure was 3.7% and 9.4% at 3 months (P value = 0.26) and 3.7% and18.9% at 6 months (P value = 0.016); the incidence of gastrointestinal bleeding was 5.6% and 37.7% at 3 months (P value < 0.001) and 9.3% and 47.2% (P value < 0.001) at 6 months; and the incidence of hepatic encephalopathy was 3.7% and 17.0% at 3 months (P value = 0.026) and 7.4% and 26.4% at 6 months (P value = 0.026) respectively.

CONCLUSION

For patients with CTPV, there were no optimal treatment. Regarding long-term efficacy, SATIPS can significantly reduce the rate of rebleeding, hepatic encephalopathy and liver failure, and is associated with better survival.

Keywords: Surgically assisted transjugular intrahepatic portosystemic shunt; Cavernous transformation of portal vein; Esophagogastric variceal bleeding; Portal hypertension; Portal vein thrombosis

Core Tip: Cavernous transformation of portal vein (CTPV) is a serious structural change of portal vein. Conventional transjugular intrahepatic portosystemic shunt (TIPS) can not save the lives of patients with CTPV. This study was conducted through a retrospective case-control study. The result showed that surgically assisted TIPS can greatly improve the operation success rate of CTPV, and significantly improve the survival rate.