Aguilar Ramírez J R, Alcantara Peraza R A, Hernández Pérez R E, Gómez Maganda y Silva T, Heredia Jarero N M, Torres Valadez F, Gómez del Campo López A
Servicio de Gastroenterología, Hospital Central Militar, México, D.F.
Rev Gastroenterol Mex. 1994 Jul-Sep;59(3):218-22.
Transjugular intrahepatic portosystemic shunt-stent (TIPS) was performed in 5 patients with cirrhosis and portal hypertension. Bleeding varices occurred in 4 patients and refractory ascites in one. We used 2 Wallstents and 3 Strecker stents. Shunt patency, recurrent variceal hemorrhage and ascites were evaluated. The shunts were created from a transjugular approach between the hepatic and portal vein, with diameters of 10 mm. Portal pressure was adequately decreased in all cases. The hospital stay, following TIPS was 3 days. Complete variceal decompression was identified endoscopically in 3 patients, and partial in one. Four shunts were patent by ultrasound and color Doppler at 1 to 6 months of follow up. One patient presented encephalopathy and one died at third day after TIPS. Initial results suggest that TIPS is an effective method of portal decompression for treatment of variceal hemorrhage and refractory ascites. The main complication was encephalopathy and only one patient died.
对5例肝硬化门静脉高压患者实施了经颈静脉肝内门体分流术（TIPS）。4例患者出现静脉曲张出血，1例出现顽固性腹水。我们使用了2个Wallstent支架和3个Strecker支架。评估了分流道通畅情况、静脉曲张再出血和腹水情况。分流道通过经颈静脉途径在肝静脉和门静脉之间建立，直径为10毫米。所有病例门静脉压力均得到充分降低。TIPS术后住院时间为3天。内镜检查发现3例患者静脉曲张完全减压，1例部分减压。随访1至6个月时，超声和彩色多普勒检查显示4个分流道通畅。1例患者出现肝性脑病，1例在TIPS术后第3天死亡。初步结果表明，TIPS是治疗静脉曲张出血和顽固性腹水的有效门静脉减压方法。主要并发症是肝性脑病，仅1例患者死亡。
