First experience of transjugular intrahepatic portosystemic shunting at multidisciplinary hospital with a liver transplantation program

Шабунин, А. В.; Бедин, В. В.; Дроздов, П. А.; Levina, O. N.; Tsurkan, V. A.; Zhuravel, O. S.

doi:10.16931/1995-5464.2022-1-48-55

Cited by 5 publications

(1 citation statement)

References 14 publications

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“…Данный шунт в современной практике довольно часто применяется при лечении портальной гипертензии и представляет собой новый путь для сообщения портальной вены с печёночными венами. Операция обеспечивает хорошую декомпрессию портальной системы, а также отличается своей малой инвазивностью [6]. Но данный вид вмешательства имеет ряд потенциальных осложнений, к числу которых относится стеноз или обтурация шунта.…”

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The first TIPS surgery performed in the Udmurt Republic in a young patient with secondary biliary cirrhosis

Styazhkina,

Zaitsev,

Bagautdinov

et al. 2023

Acta biomedica scientifica

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Treatment of patients with iatrogenic injuries of the biliary tract is the most difficult and important section in hepatobiliary surgery. When analyzing the causes, it was found that in 70–94 % of cases this type of injury is observed during cholecystectomy. We present a rare clinical case of the development of secondary biliary cirrhosis due to iatrogenic trauma of the biliary tract. This injury caused long-term suffering for the patient due to the further development of complications of cirrhosis, specifically of portal hypertension. The latter caused repeated recurrent profuse bleeding from varicose veins of the esophagus. The use of a minimally invasive transjugular intrahepatic portosystemic shunt procedure for the first time in the Udmurt Republic was of particular relevance in solving this problem. This procedure has become a key one in solving the abovementioned problems and will become the preventive measure for the cirrhosis progression in the future. It is also important to focus on prophylactic measures aimed at preventing iatrogenic injuries of the biliary tract, as this problem can cause irreversible complications. Prevention should include adequate examination and visualization of the bile ducts and gallbladder before surgery, their careful mobilization, compliance with the rules of operation with electrosurgical instruments, as well as the use of additional minimally invasive techniques such as choledoscopy, cholangiography and intraoperative ultrasound. Besides that, all manipulations should be carried out under strict control and clear visualization of instruments and anatomical structures of organs. The article provides a detailed description of the technique of transjugular intrahepatic portosystemic shunt surgery, as well as presents X-ray images obtained during this operation.

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Section: резюмеunclassified

The first TIPS surgery performed in the Udmurt Republic in a young patient with secondary biliary cirrhosis

Styazhkina,

Zaitsev,

Bagautdinov

et al. 2023

Acta biomedica scientifica

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Optimization stages of transjugular intrahepatic portosystemic shunt technique as a treatment method for portal hypertension complications

Garbuzenko

2024

Ann. hir. gepatol.

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Aim. To describe the milestones to optimize of the technique of transjugular intrahepatic portosystemic shunt.Materials and methods. The PubMed and Embase databases, the Web of Science platform, the Google Scholar retrieval system, the Cochrane Database of Systematic Reviews, the eLIBRARY.RU scientific electronic library, and the reference lists were used to search for articles. Articles corresponding to the aim of the review were selected for 1969-2023. The inclusion criteria were limited to technical solutions related to optimize of the technique of transjugular intrahepatic portosystemic shunt.Results. Innovative ideas, subsequent experimental studies and preliminary experience in liver cirrhosis patients contributed to the introduction of transjugular intrahepatic portosystemic shunt into clinical practice. At the moment, the main achievement to optimize of the technique of transjugular intrahepatic portosystemic shunt is progress in the qualitative characteristics of stents. The transition from bare metal stents to expandable polytetraﬂuoroethylene-covered stent graft made it possible to largely prevent shunt dysfunction. However, the issue of its optimal diameter, contributing to an effective reduction of portal pressure without the risk of developing hepatic encephalopathy, which is one of the most common complications of transjugular intrahepatic portosystemic shunt, remains relevant.Conclusion. Further to optimize of the technique of transjugular intrahepatic portosystemic shunt, as well as careful selection of patients based on cognitive indicators, nutritional status and assessment of liver function will reduce the incidence of hepatic encephalopathy and improve treatment results.

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Balloon-occluded retrograde transvenous obliteration in patients with liver cirrhosis and variceal transformation of gastric veins: first experiences of Botkin hospital

Shabunin,

Bagatelia,

Bedin

et al. 2024

Ann. hir. gepatol.

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Aim. To analyze first experiences and demonstrate the results of balloon-occluded retrograde transvenous obliteration in patients with liver cirrhosis and variceal transformation of the gastric veins.Materials and methods. In the period from November 2023 to August 2024, balloon-occluded retrograde transvenous obliteration was performed on six male patients with liver cirrhosis and gastric varices for secondary prevention of bleeding. The mean age of the patients comprised 56.5 years. Significant gastrorenal shunt and predominantly right-sided drainage of gastroesophageal varices were considered technical indications for the procedure.Results. No fatalities or complications necessitating reoperation were reported. The follow-up period revealed no recurrences of bleeding. The overall survival rate over six months comprised 100%. Progression of gastric varices was noted in two out of six patients: one patient underwent a repeat procedure, while the other underwent liver transplantation.Conclusion. Balloon-occluded retrograde transvenous obliteration is recognized as a safe and effective radiological intervention for addressing complications associated with portal hypertension. However, it obtains several limitations and potential adverse effects, which necessitate careful monitoring during follow-up.

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First experience of transjugular intrahepatic portosystemic shunting at multidisciplinary hospital with a liver transplantation program

Cited by 5 publications

References 14 publications

The first TIPS surgery performed in the Udmurt Republic in a young patient with secondary biliary cirrhosis

The first TIPS surgery performed in the Udmurt Republic in a young patient with secondary biliary cirrhosis

Optimization stages of transjugular intrahepatic portosystemic shunt technique as a treatment method for portal hypertension complications

Balloon-occluded retrograde transvenous obliteration in patients with liver cirrhosis and variceal transformation of gastric veins: first experiences of Botkin hospital

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