| Objective: Patients with cirrhosis and portal vein thrombosis(PVT)are included in this study,to compare the clinical outcomes between esophageal variceal ligation(EVL)and transjugular intrahepatic portosystemic shunt(TIPS)for prevention of esophageal variceal(EV)rebleeding.Methods: We retrospectively analyzed the patients with cirrhosis and PVT who underwent EVL or TIPS for the first time in the second affiliated hospital of Chongqing medical university.According to the exclusion criteria,we divided patients into EVL group(n=33)and TIPS group(n= 34),following up to 2016.11.30,analyzing clinical outcomes,including operation complications,PVT changes,rebleeding,hepatic encephalopathy(HE)and mortality.Results: The 1-,2-,3-,and 4-year TIPS patency rate was 79.20%,72.84%,53.96%,53.96%.The 1-,2-,3-,and 4-year recanalization rate of thrombus was 0,13.14%,17.71% and 17.71% in EVL group,respectively,and 36.91%,57.09%,74.57% and 87.29% in TIPS group,with a clear statistical difference(P < 0.01).The 1-,2-,3-,and 4-year cumulative rate free of rebleeeding was 84.85%,67.29%,50.61%,50.61% in EVL group,respectively,and 79.41%,76.24%,76.24%,38.12% in TIPS group,with no statistical difference(P = 0.567).The 1-,2-,3-,and 4-year cumulative rate of HE was 6.25%,10.16%,14.65%,14.65%,respectively,and 27.27%,31.82%,31.82%,31.82% in TIPS group,with no obviously statistical difference(P = 0.05).The 1-,2-,3-,and 4-year cumulative survival rate was 93.93%,90.58%,90.58%,84.92% in EVL group,respectively,and 94.12%,89.16%,82.31%,82.31% in TIPS group,with no statistical difference(P = 0.742).Conclusion: Although TIPS group conduced to PVT recanalization compared with EVL group,HE,rebleeding and survival showed no statistical difference in two groups in cirrhosis patients with PVT and EV.This suggested that even with PVT,EVL and TIPS could be used as first-line options to prevent EV rebleeding,but improving the TIPS operation and postoperative management may reduce the stent dysfunction even rebleeding rate. |
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