Chinese Hepatolgy ›› 2024, Vol. 29 ›› Issue (5): 516-520.

• Liver Fibrosis & Cirrhosis • Previous Articles     Next Articles

The impacts of transjugular intrahepatic portosystemic shunt on the portal vein diameter and long-term outcome of liver cirrhotic patients with portal hypertension

MA Zhi-gang1, LIU Li-li2, WANG Xu3, FENG Peng-li4, YANG Fan5, YANG Yong-bin6   

  1. 1. Catheter Intervention Room, Baoding Second Central Hospital, Hebei 072750, China;
    2. Department of Health Examination, Dingzhou People′s Hospital, Hebei 073000, China;
    3. Department of Gastroenterology, Baoding Second Central Hospital, Hebei 072750, China;
    4. CT Room, Baoding Second Central Hospital, Hebei 072750, China;
    5. Department of Pharmacy, Baoding Second Central Hospital, Hebei 072750, China;
    6. Department of Cardiovascular Surgery, Hebei Provincial People′s Hospital, Shijiazhuangi 050051, China
  • Received:2023-05-28 Online:2024-05-31 Published:2024-08-28

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Abstract: Objective To investigate the impacts of transjugular intrahepatic portosystemic shunt (TIPS) on portal vein diameter (PVD) and long-term outcome of patients with liver cirrhosis and portal hypertension (PHT). Methods A total of 100 patients with liver cirrhosis and PHT admitted from January 2017 to January 2020 were randomly grouped into a control group (50 cases, treated with pericardial revascularization) and a study group (50 cases, treated with TIPS) using a random number table method. The clinical data of all patients were collected and the liver hemodynamics, liver function, and long-term efficacy of the treatments in both groups of patients were compared. Results One day before surgery, there were no obvious differences in PVD, portal venous blood flow (PVF), splenic venous inner diameter (SVD), splenic venous blood flow (SVF), portal venous flow velocity (PVV), splenic venous flow velocity (SVV), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBIL) between the two groups (P>0.05). At 7d after surgery, The PVD [(1.15±0.22) cm vs (1.53±0.32) cm], PVF [(774.45±101.28) mL vs (845.33±120.39) mL], SVD [(1.17±0.21) cm vs (1.32±0.27) cm], SVF [(304.47±63.38) mL vs (400.01±74.12) mL], ALT [(38.45±8.61) U/L vs (50.26±10.05) U/L], AST [(39.18±8.97) U/L vs (48.51±10.13) U/L], and TBil [(28.19±6.08) μmol/L vs (39.53±8.96) μmol/L] were decreased and improved more in the study group when compared with those in the control group (P<0.05), whereas PVV [(45.69±9.98) cm/s vs (30.08±6.57) cm/s] and SVV [(24.76±6.02) cm/s vs (18.96±4.04) cm/s] were increased (P<0.05). The survival rate of PHT patients with liver cirrhosis in both groups decreased with the increase of postoperative time, and the survival rate in the study group was obviously higher than that in the control group in 3 years after surgery (P<0.05), moreover, the total incidence of adverse events in the study group was lower than that in the control group in three years after surgery, however, there was no obvious difference between the two groups (P>0.05). Conclusion TIPS is effective in the treatment of PHT in patients with liver cirrhosis, and may obviously improve liver hemodynamics and liver function in patients with liver cirrhosis and PHT, with a good long-term effect on the patients.

Key words: Transjugular intrahepatic portosystemic shunt, Pericardial vascular disconnection, Liver cirrhosis with portal hypertension, Diameter of portal vein, Long term efficacy