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经颈静脉肝内门体分流术(TIPS)失败后采用联合经颈静脉/经皮肝内门体分流术(cTIPS)治疗门静脉海绵样变性。

Combined transjugular/percutaneous intrahepatic portosystemic shunts (cTIPS) for cavernous transformation of the portal vein after conventional transjugular approach TIPS failure.

机构信息

Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Yellow River Hospital Attached Henan University of Science and Technology, Sanmeixia, China.

出版信息

Medicine (Baltimore). 2023 Apr 21;102(16):e33608. doi: 10.1097/MD.0000000000033608.

Abstract

This study aim was to compare the safety and efficacy of combined transjugular/percutaneous intrahepatic portosystemic shunts (cTIPS) and transjugular intrahepatic portosystemic shunt (TIPS) in cirrhotic patients with cavernous transformation of the portal vein (CTPV) after conventional transjugular approach TIPS failure. Cirrhotic patients who were diagnosed as CTPV and treated by cTIPS or TIPS between July 2012 and April 2022 were retrospectively analyzed. Patients' characteristics and clinical data were recorded. The clinical outcomes, long-term survival rates and patency rates between the 2 groups were compared. A total of 68 patients with CTPV were enrolled, of whom 23 were treated with TIPS and 45 with cTIPS. The initial technical success was 30.9% in TIPS group and 91.1% in cTIPS group. The hospitalization days increased significantly in the cTIPS group compared with TIPS group (P = .0131). However, the complication rate, patency rates and survival rates were similar between the 2 groups. In conclusion, cTIPS appeared to be safe and effective in cirrhotic patients with CTPV after conventional transjugular approach TIPS failure.

摘要

这项研究旨在比较经颈静脉肝内门体分流术(TIPS)联合经皮经肝内门体分流术(cTIPS)与传统 TIPS 失败后经颈静脉肝内门体分流术(TIPS)治疗肝硬化伴海绵样变门静脉(CTPV)患者的安全性和疗效。回顾性分析了 2012 年 7 月至 2022 年 4 月期间接受 cTIPS 或 TIPS 治疗的 CTPV 诊断为肝硬化患者的特征和临床数据。比较了两组患者的临床结局、长期生存率和通畅率。共纳入 68 例 CTPV 患者,其中 23 例行 TIPS 治疗,45 例行 cTIPS 治疗。TIPS 组的初始技术成功率为 30.9%,cTIPS 组为 91.1%。cTIPS 组的住院天数明显多于 TIPS 组(P =.0131)。然而,两组患者的并发症发生率、通畅率和生存率相似。结论:对于传统 TIPS 失败后伴有 CTPV 的肝硬化患者,cTIPS 似乎是安全有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf4d/10118327/2607c798a58f/medi-102-e33608-g001.jpg

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