Transjugular intrahepatic portal shunt in the treatment of portal hypertension due to cirrhosis: single center experience

Chen, Yun; Qiu, Hanyu; Zhang, Xiaomei

doi:10.1186/s12893-019-0659-5

Cited by 10 publications

(5 citation statements)

References 21 publications

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“…Частота дисфункции стента в отдаленном периоде после TIPS связана с его конструкцией: после установки покрытого стента она варьирует от 24 до 44%, после установки непокрытого стента увеличивается до 64%. Рецидив ПЖК развивается в 15-19% наблюде-ний, а энцефалопатия -в 20-31% [4,[20][21][22]. Собственный опыт TIPS оказался сопоста вимым с результатами, представленными в литературе.…”

Section: Discussionunclassified

Minimally invasive ways to treat and prevent gastroesophageal portal bleeding

et al. 2022

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Aim. To analyze the results of minimally invasive techniques to prevent and treat gastroesophageal bleeding in patients with cirrhosis.Materials and methods. The study included 997 patients with liver cirrhosis: Child-Pugh class A – 21.7%; class B – 48.8%; class C – 29.5%. Esophageal varices of Grades III–IV were diagnosed in 95.5% of the patients, while gastric varices were observed in 17.4% of the patients. The following methods were used: endoscopic ligation, endoscopic sclerotherapy, TIPS, laparoscopic azygoportal disconnection, and distal splenorenal anastomosis.Results. Following endoscopic procedures aimed at preventing the onset of gastroesophageal bleeding, variceal recurrence and bleeding were observed in 35.9% and 18.6% of cases, respectively. The efficacy of endoscopic ligation in case of bleeding amounted to 91.2%. Multiple endoscopic procedures provided means to treat esophageal and gastric varices in 56.2% of the patients. Rebleeding was observed in 9.3% of the patients, while esophageal and gastric varices persisted in 34.3% of the patients. TIPS was found to significantly reduce portal pressure and the grade of varices, with encephalopathy developing in 41.4% of the patients. In the long-term period, stent dysfunction was diagnosed in 22.5% of cases, while bleeding recurred in 10%. Laparoscopic azygoportal disconnection contributed to the regression of esophageal and gastric varices. In the long-term period, bleeding recurred in 42.3% of cases. Laparoscopic distal splenorenal anastomosis reliably prevented the recurrence of bleeding. No shunt thrombosis or lethal outcomes were observed, while the incidence of encephalopathy amounted to 14.7%.Conclusion. A sufficient number of minimally invasive methods are currently available in the treatment and prevention of gastroesophageal portal bleeding. A case-specific approach to the choice of measures aimed at treating and preventing gastroesophageal bleeding in patients with cirrhosis is required, taking into account the degree of decompensation of portal hypertension and the severity of liver dysfunction.

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Section: Discussionunclassified

Minimally invasive ways to treat and prevent gastroesophageal portal bleeding

et al. 2022

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“…its correction. After the procedure, the patient developed HE, a problem that occurs in only 12% of patients who undergo TIPS, and that commonly develops 24 months after the procedure [10].…”

Section: Discussionmentioning

confidence: 99%

“…EV is directly related to portal hypertension, which caused increased portal resistance, developing collateral circulation and varices [15]. Due to portal hypertension, the patient underwent the TIPS [6], in which the shunt reduces the resistance of the portal vein, diminishing portal hypertension in patients with cirrhosis and relieving ascites [10]. HE was developed close after the TIPS, requiring a new hospitalization and stent implantation to occlude the TIPS.…”

Section: Discussionmentioning

confidence: 99%

Early Hepatic Encephalopathy after a Transjugular Intrahepatic Portosystemic Shunt Procedure: Case Report

Baron¹,

Scherer²,

Santos³

et al. 2021

OJGas

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Patients with decompensated hepatic cirrhosis may present systemic alterations and dysfunction of multiple organs. Ascites, portal hypertension, esophageal varices, and hepatic encephalopathy are common complications arising from cirrhosis. The aim of this paper is to report a case of a patient with liver cirrhosis and the complications of a transjugular intrahepatic portosystemic shunt. Male, elderly, and ex-alcoholic, diagnosed with liver cirrhosis, ascites, and esophageal varices. He underwent transjugular intrahepatic portosystemic shunt due to portal hypertension and returned to the hospital after 24 hours with agitation and mental confusion. He had a bowel movement stop, neurological worsening, loss of renal function, hepatic hydrothorax, hepatic encephalopathy, hypernatremia, hypocalcemia, and hy-How to cite this paper:

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“…Transjugular intrahepatic portosystemic shunt (TIPS) is an interventional radiological procedure that significantly reduces portal pressure[ 3 ], prevents decompensation and improves survival of cirrhotic patients[ 4 ]. During TIPS placement, direct portal pressures are measured and used to calculate the portosystemic pressure gradient (PSPG).…”

Section: Introductionmentioning

confidence: 99%

Milestones to optimize of transjugular intrahepatic portosystemic shunt technique as a method for the treatment of portal hypertension complications

Garbuzenko

2024

World J Hepatol

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This editorial describes the milestones to optimize of transjugular intrahepatic portosystemic shunt (TIPS) technique, which have made it one of the main methods for the treatment of portal hypertension complications worldwide. Innovative ideas, subsequent experimental studies and preliminary experience of use in cirrhotic patients contributed to the introduction of TIPS into clinical practice. At the moment, the main achievement in optimize of TIPS technique is progress in the qualitative characteristics of stents. The transition from bare metal stents to extended polytetrafluoroethylene–covered stent grafts made it possible to significantly prevent shunt dysfunction. However, the question of its preferred diameter, which contributes to an optimal reduction of portal pressure without the risk of developing post-TIPS hepatic encephalopathy, remains relevant. Currently, hepatic encephalopathy is one of the most common complications of TIPS, significantly affecting its effectiveness and prognosis. Careful selection of patients based on cognitive indicators, nutritional status, assessment of liver function, etc. , will reduce the incidence of post-TIPS hepatic encephalopathy and improve treatment results. Optimize of TIPS technique has significantly expanded the indications for its use and made it one of the main methods for the treatment of portal hypertension complications. At the same time, there are a number of limitations and unresolved issues that require further randomized controlled trials involving a large cohort of patients.

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Transjugular intrahepatic portal shunt in the treatment of portal hypertension due to cirrhosis: single center experience

Cited by 10 publications

References 21 publications

Minimally invasive ways to treat and prevent gastroesophageal portal bleeding

Minimally invasive ways to treat and prevent gastroesophageal portal bleeding

Early Hepatic Encephalopathy after a Transjugular Intrahepatic Portosystemic Shunt Procedure: Case Report

Milestones to optimize of transjugular intrahepatic portosystemic shunt technique as a method for the treatment of portal hypertension complications

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