Transjugular Intrahepatic Portosystemic Shunt (TIPS) For Cavernous Transformation Of Portal Vein (CTPV)

Objective:To asses the feasibility, safety, and efficacy of TIPS for cavernous transformation of portal vein(CTPV).Materials and Method:20 patients with cavernous transformation of portal vein were enrolled from Shandong Provincial Hospital from October 2010 to February 2015 and they were all treated with TIPS. They were followed up until either death or March 2015. Observe the complication after opercation, including shunt dysfunction, hepatic encephalopathy, abdominal pain, upper gastrointestinal bleeding. Data were analyzed using the Student’s t-test or Fisher’s exact test. The Statistical Package for Social Sciences (SPSS) version 19.0 was used.Results:TIPS were successfully placed in 75% (15/20) of patients. The surgery procedures included transjugular/transfemoral approach(n=2), combined transjugular/transhepatic approach (n=8), combined transjugular/transsplenic approach (n=5). Obliteration of gastroesophageal varices were performed in 7 cases of TIPS success group. No procedure-related complication occurred during operation. The mean duration of operation was 4.5 hours. Portal venous pressure was significantly reduced in TIPS success group (31.56±9.25 vs.19.33±5.79mmHg, p<0.05). In TIPS success group, ten patients achieved remission of symptoms, two patients suffer from shunt dysfunction,3 patients died of upper gastrointestinal bleeding, hepatic failure, acute respiratory distress syndrome respectively.Conclusion:TIPS is a minimal invasion procedures which are feasible, safe and effective for selected patients with cavernous transformation of portal vein.