Forster J, Siegel E L, Delcore R, Payne K M, Laurin J, Kindscher J D
Department of Surgery, University of Kansas Medical Center, Kansas City 66160-7309, USA.
Am J Surg. 1996 Nov;172(5):536-9; discussion 539-40. doi: 10.1016/S0002-9610(96)00239-5.
Transjugular intrahepatic portosystemic shunts (TIPS) are an established method for the treatment of the complications of portal hypertension. Recent reports have suggested that TIPS require frequent follow-up and may interfere with orthotopic liver transplantation (OLT).
Retrospective chart review was performed of ultrasound studies, angiographic studies, and complications of the first 100 patients treated consecutively with TIPS from February 1992 through October 1995.
Ninety-seven patients had functional TIPS. Thirty-one percent of patients treated emergently survived, significantly less than the 96% survival of elective patients. Fifty percent of the shunts were found to require angioplasty by 5 months. Seventeen patients treated with OLT did well, without intraoperative bleeding problems, and are alive.
The TIPS method treats successfully the complications of portal hypertension but requires careful follow-up. The technique may be used prior to OLT. For non-OLT candidates, the cost effectiveness of TIPS versus surgical shunting remains in question.
经颈静脉肝内门体分流术（TIPS）是治疗门静脉高压并发症的一种既定方法。最近的报告表明，TIPS需要频繁随访，并且可能会干扰原位肝移植（OLT）。
对1992年2月至1995年10月连续接受TIPS治疗的前100例患者的超声检查、血管造影研究及并发症进行回顾性图表分析。
97例患者的TIPS功能良好。急诊治疗的患者中有31%存活，明显低于择期治疗患者96%的存活率。到5个月时发现50%的分流需要进行血管成形术。17例接受OLT治疗的患者情况良好，术中无出血问题，且存活。
TIPS方法成功治疗了门静脉高压并发症，但需要仔细随访。该技术可在OLT之前使用。对于不适合OLT的患者，TIPS与外科分流术相比的成本效益仍存在疑问。
