Abstract: Objective To study the clinical value of transjugular intrahepatic portosystemic shunt (TIPS) and gastric coronary vein embolization (GCVE) in the treatment of portal hypertension with massive upper gastrointestinal hemorrhage. Methods Seventy-four patients with portal hypertension and massive upper gastrointestinal hemorrhage in our hospital were selected as study subjects. There were 37 cases undergoing TIPS and GCVE in the observation group, and 37 cases treated with splenectomy and pericardial devascularization in the control group. The postoperative complications were compared between the 2 groups. The international normalized ratio (INR), serum albumin, total bilirubin (TBIL) and fibrinogen (Fib) levels before and after operation were compared between the 2 groups. The postoperative thrombosis and 1-year rebleeding rate were recorded. Results There were no significant differences in the levels of albumin, INR, TBIL and Fib between the 2 groups(P> 0.05). There were no significant differences in the incidences of postoperative ascites, postoperative pain, incision infection and lung infection between the 2 groups (P> 0.05). There were significant differences in the incidence of postoperative hepatic encephalopathy and 1-year rebleeding rate between the 2 groups (P < 0.05). In the observation group, there was significant difference in the incidence of hepatic encephalopathy among patients with different liver function grades after operation (P<0.05). Conclusion The TIPS combined with GCVE has similar efficacy to splenectomy plus pericardial devascularization in the treatment of portal hypertension with massive upper gastrointestinal hemorrhage. The 1-year rebleeding rate after TIPS combined with GCVE is lower, but the risk of postoperative hepatic encephalopathy is higher.

Key words: Transjugular intrahepatic portosystemic shunt, Gastric coronary vein embolization, Portal hypertension, Gastrointestinal hemorrhage, Clinical value