经颈静脉肝内门体分流术的转归：一座“没有尽头的桥”。
Outcomes after transjugular intrahepatic portosystemic stent shunt: a "bridge" to nowhere.
机构信息
University of South Florida, Department of Surgery, Tampa, FL, USA.
出版信息
Am J Surg. 2013 Apr;205(4):441-6. doi: 10.1016/j.amjsurg.2012.06.005. Epub 2013 Jan 30.
BACKGROUND
Transjugular intrahepatic portosystemic stent shunt (TIPS) has become the modality of choice for complicated portal decompression. This study was undertaken to determine outcomes after TIPS and the usefulness of TIPS as a "bridge" to transplantation.
METHODS
Patients undergoing TIPS from 2001 to 2010 at a teaching hospital with a transplant program were studied. The median data are presented.
RESULTS
TIPS was undertaken in 256 patients. TIPS decreased portal vein-inferior vena cava (IVC) gradients from 17 to 5 mm Hg (P < .001). Reinterventions were undertaken in 54 patients (21%). Survival after TIPS was 26 months; liver transplantation was undertaken in 35 (14%) patients.
CONCLUSIONS
TIPS effectively decompresses portal hypertension but leads to frequent reinterventions and short survival. After TIPS, liver transplantation is uncommonly undertaken. TIPS is a "bridge" to transplantation that is seldom "crossed," and TIPS continues to be plagued by frequent reinterventions. Outcomes after TIPS and the infrequency of transplantation after TIPS make it difficult to recommend on merit.
背景
经颈静脉肝内门体分流术（TIPS）已成为复杂门脉减压的首选方法。本研究旨在确定 TIPS 后的结果以及 TIPS 作为移植“桥梁”的作用。
方法
在一家有移植项目的教学医院，对 2001 年至 2010 年期间接受 TIPS 的患者进行了研究。中位数数据被呈现出来。
结果
在 256 例患者中进行了 TIPS。TIPS 使门静脉-下腔静脉（IVC）梯度从 17mmHg 降至 5mmHg（P＜0.001）。54 例患者（21%）需要再次介入治疗。TIPS 后的生存率为 26 个月；35 例（14%）患者接受了肝移植。
结论
TIPS 有效地降低了门脉高压，但导致频繁的再介入治疗和较短的生存时间。TIPS 后，肝移植很少进行。TIPS 是移植的“桥梁”，但很少被“跨越”，TIPS 仍然受到频繁再介入治疗的困扰。TIPS 后的结果和 TIPS 后肝移植的不常见性使得很难仅凭优点推荐 TIPS。
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