Yin Xiaochun, Gu Lihong, Zhang Ming, Yin Qin, Xiao Jiangqiang, Wang Yi, Zou Xiaoping, Zhang Feng, Zhuge Yuzheng
Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
Front Med (Lausanne). 2022 May 4;9:834106. doi: 10.3389/fmed.2022.834106. eCollection 2022.
Transjugular intrahepatic portosystemic shunt (TIPS) is a well-established procedure for treating complications of portal hypertension. Due to the complexity of anatomy and difficulty of the puncture technique, the procedure itself might brought potential complications, such as puncture failure, bleeding, infection, and, rarely, death. The aim of this study is to explore the incidence, management, and outcome of TIPS procedure-related major complications using covered stents.
Patients who underwent TIPS implantation from January 2015 to December 2020 were recruited retrospectively. Major complications after TIPS were screened and analyzed.
Nine hundred and forty-eight patients underwent the TIPS procedure with 95.1% (n = 902) technical success in our department. TIPS procedure-related major complications occurred in 30 (3.2%) patients, including hemobilia ( = 13; 1.37%), hemoperitoneum ( = 7; 0.74%), accelerated liver failure ( = 6; 0.63%), and rapidly progressive organ failure ( = 4; 0.42%). Among them, 8 patients died because of hemobilia ( = 1), accelerated liver failure ( = 4), and rapidly progressive organ failure ( = 3).
The incidence of major complications related to TIPS procedure is relatively low, and some of them could recover through effective medical intervention. In our cohort, the overall incidence is about 3%, which causes 0.84% death. The most fatal complication is organ failure and hemobilia.
经颈静脉肝内门体分流术（TIPS）是治疗门静脉高压并发症的成熟术式。由于解剖结构复杂及穿刺技术难度大，该手术本身可能带来潜在并发症，如穿刺失败、出血、感染，甚至罕见的死亡。本研究旨在探讨使用覆膜支架的TIPS手术相关严重并发症的发生率、处理方法及结局。
回顾性纳入2015年1月至2020年12月接受TIPS植入术的患者。对TIPS术后的严重并发症进行筛查与分析。
在我们科室，948例患者接受了TIPS手术，技术成功率为95.1%（n = 902）。30例（3.2%）患者发生了TIPS手术相关严重并发症，包括胆道出血（n = 13；1.37%）、腹腔积血（n = 7；0.74%）、急性肝衰竭（n = 6；0.63%）和快速进展性器官功能衰竭（n = 4；0.42%）。其中，8例患者因胆道出血（n = 1）、急性肝衰竭（n = 4）和快速进展性器官功能衰竭（n = 3）死亡。
TIPS手术相关严重并发症的发生率相对较低，部分患者可通过有效的药物干预恢复。在我们的队列中，总体发生率约为3%，导致0.84%的死亡率。最致命的并发症是器官功能衰竭和胆道出血。
