Li Xiao-Yan, Li Yao, Li Wen-Qiang, Ju Shuai, Dong Zhi-Hui, Luo Jian-Jun
Vascular and Wound Center, Jinshan Hospital, Fudan University, Shanghai 201508, China.
Department of Vascular Surgery, Institute of Vascular Surgery, Zhongshan Hospital Fudan University, Shanghai 200032, China.
World J Gastrointest Surg. 2024 Sep 27;16(9):2870-2877. doi: 10.4240/wjgs.v16.i9.2870.
Transjugular intrahepatic portosystemic shunt (TIPS) is a pivotal intervention for managing esophagogastric variceal bleeding in patients with chronic hepatic schistosomiasis.
To evaluate the efficacy of digital subtraction angiography image overlay technology (DIT) in guiding the TIPS procedure.
We conducted a retrospective analysis of patients who underwent TIPS at our hospital, comparing outcomes between an ultrasound-guided group and a DIT-guided group. Our analysis focused on the duration of the portosystemic shunt puncture, the number of punctures needed, the total surgical time, and various clinical indicators related to the surgery.
The study included 52 patients with esophagogastric varices due to chronic hepatic schistosomiasis. Results demonstrated that the DIT-guided group experienced significantly shorter puncture times ( < 0.001) and surgical durations ( = 0.022) compared to the ultrasound-guided group. Additionally, postoperative assessments showed significant reductions in aspartate aminotransferase, B-type natriuretic peptide, and portal vein pressure in both groups. Notably, the DIT-guided group also showed significant reductions in total bilirubin ( = 0.001) and alanine aminotransferase ( = 0.023).
The use of DIT for guiding TIPS procedures highlights its potential to enhance procedural efficiency and reduce surgical times in the treatment of esophagogastric variceal bleeding in patients with chronic hepatic schistosomiasis.
经颈静脉肝内门体分流术（TIPS）是治疗慢性血吸虫病患者食管胃静脉曲张出血的关键干预措施。
评估数字减影血管造影图像叠加技术（DIT）在引导TIPS手术中的疗效。
我们对在我院接受TIPS手术的患者进行了回顾性分析，比较了超声引导组和DIT引导组的手术结果。我们的分析重点是门体分流穿刺的持续时间、所需穿刺次数、总手术时间以及与手术相关的各种临床指标。
该研究纳入了52例因慢性血吸虫病导致食管胃静脉曲张的患者。结果表明，与超声引导组相比，DIT引导组的穿刺时间显著缩短（<0.001），手术持续时间也显著缩短（=0.022）。此外，术后评估显示两组的天门冬氨酸氨基转移酶、B型利钠肽和门静脉压力均显著降低。值得注意的是，DIT引导组的总胆红素（=0.001）和丙氨酸氨基转移酶（=0.023）也显著降低。
使用DIT引导TIPS手术突出了其在提高慢性血吸虫病患者食管胃静脉曲张出血治疗中的手术效率和缩短手术时间方面的潜力。
