Somberg K A
Liver Transplantation Program, University of California, San Francisco, CA 94143-0630, USA.
Semin Gastrointest Dis. 1995 Jul;6(3):165-77.
TIPS provides a side-to-side portosystemic shunt without a major abdominal operation. Although TIPS is relatively less invasive, it is associated with similar hemodynamic alterations as surgically created side-to-side shunts. An important difference is that a mild degree of portal hypertension is maintained with TIPS similar to small diameter shunts. TIPS provides effective portal decompression and prevents variceal hemorrhage. However, the risk of encephalopathy is relatively high and stenosis is a long-term concern in many patients. An important advance in the future use of TIPS will be tailoring the diameter of the shunt to optimize regional and systemic hemodynamics in a given individual to minimize the risk of bleeding or to decrease ascites accumulation while limiting the risk of hepatic encephalopathy and liver failure.
经颈静脉肝内门体分流术（TIPS）无需进行大型腹部手术即可建立侧侧门体分流。尽管TIPS的侵入性相对较小，但它会引起与手术创建的侧侧分流相似的血流动力学改变。一个重要的区别是，TIPS会维持轻度门静脉高压，类似于小直径分流。TIPS可有效降低门静脉压力并预防静脉曲张出血。然而，肝性脑病的风险相对较高，并且狭窄是许多患者长期关注的问题。TIPS未来应用的一个重要进展将是根据个体情况调整分流直径，以优化局部和全身血流动力学，从而将出血风险降至最低或减少腹水积聚，同时限制肝性脑病和肝衰竭的风险。
