A Case-control Study Of Transjugular Intrahepatic Portosystem Shunt And Combined Gastric Coronary Vein Embolization For The Treatment Of Upper Gastrointestinal Bleeding In Cirrhosis

Objective:To compare the incidence of shunt dysfunction,variceal rebleeding and death between patients treated with TIPS alone and those treated with TIPS in combination with variceal embolization.Methods:A retrospective analysis showed that 71 patients with liver cirrhosis and upper gastrointestinal bleeding were treated with TIPS surgery from November 2015 to November 2020,and their clinical data were collected.Among them,38 patients received TIPS surgery,and 33 patients received TIPS combined with gastric coronary vein embolization surgery.Changes in blood biochemical indexes of patients before and after surgery were analyzed.Postoperative stent restenosis,rebleeding and survival were followed up.Results:After the operation,the bilirubin(TBIL),INR and PT of the two groups were higher than before the operation(p<0.05),and the creatinine(Cr)level and albumin(ALB)were lower than before the operation(p<0.05).Although there were no significant differences in the 5-year cumulative shunt patency,cumulative survival,and incidence of recurrent variceal rupture bleeding between the two groups(P>;0.05),but the incidence of recurrent variceal rupture bleeding in one year with TIPS combined with gastric coronary vein embolization was lower than that with TIPS alone(6.1%;23.7%,p = 0.049).Conclusion:Embolization of the varicose gastric coronary vein reduces the risk of recurrent cirrhosis of the upper gastrointestinal tract bleeding within 12 months after TIPS,which can improve patients’ quality of life.