Efficacy of transjugular intrahepatic portosystemic shunts in treating cirrhotic esophageal-gastric variceal bleeding

ARTICLE HIGHLIGHTS

Research background

The transjugular intrahepatic portosystemic shunt (TIPS) is an important method for treating upper gastrointestinal bleeding caused by portal hypertension in patients with liver cirrhosis. Nevertheless, additional research endeavors are needed to elucidate the precise therapeutic efficacy of TIPS for managing variceal bleeding and to discern its implications for patient prognosis.

Research motivation

The primary objective of this study was to scrutinize the efficacy of TIPS for the management of esophageal-gastric variceal bleeding (EGVB) in individuals with cirrhosis and to evaluate its consequential influence on patient prognosis. This study endeavors to meticulously assess the advantageous outcomes associated with TIPS, aiming to furnish evidence-based insights that can inform and enhance clinical decision-making processes.

Research objectives

Through in-depth research on the therapeutic effect and prognosis of TIPS placement, this paper aimed to provide additional comprehensive information for clinical doctors to better guide treatment decision-making and improve disease management.

Research methods

A retrospective study was undertaken involving 92 patients afflicted with cirrhotic EGVB who were admitted to our hospital between September 2020 and September 2022. The patient cohort was dichotomized into two groups based on distinct treatment modalities: The TIPS treatment group (n = 50) and the percutaneous transhepatic variceal embolization treatment group (n = 42). Comparative analyses were also conducted on the varicosity status, hemodynamic parameters, and quality of life of the patients in both groups, both preoperatively and postoperatively. Additionally, a comparative examination was undertaken to evaluate the 1-year rebleeding and survival rates between the two treatment groups.

Research results

Postoperative varicosity improved in both groups, with the study group showing better outcomes. Portal vein flow velocity increased and portal vein diameter decreased postoperatively, again with the study group demonstrating superior results. Postoperative platelet count and white blood cell counts were greater in both groups, and the study group had higher scores in all dimensions of life quality. Furthermore, compared with those in the control group, the one-year rebleeding rate in the study group was notably lower, although no significant difference was detected in the one-year postoperative survival rate between the two cohorts.

Research conclusions

TIPS treatment has demonstrated robust efficacy in the management of cirrhotic EGVB by significantly diminishing varicosity and enhancing hemodynamics in affected patients. This intervention not only represents a safer alternative but also contributes to a more favorable prognosis in this clinical context.

Research perspectives

Cirrhosis, as a grave and chronic ailment, profoundly influences both the quality of life and the life expectancy of afflicted individuals. Consequently, a thorough exploration of treatment modalities and prognosis pertaining to EGVB induced by cirrhosis is of paramount importance, as this review offers invaluable insights and reference points for clinicians engaged in clinical practice.