Changes Of Liver Volume And Liver Function In Patients With Portal Hypertension After TIPS In The Short And Medium Term

Objective To study the changes and significance of LV and liver function after TIPS.Methods We selected 56 patients with liver cirrhosis and portal hypertension who were treated by TIPS in the Department of Vascular Surgery of Gan Su Provincial Hospital from April 2018 to February 2020 and met the inclusion criteria.First,the LV,liver function scores and clinical data of the patients before and after surgery were compared.Secondly,the clinical data between the postoperative LV enlargement group and the LV reduction group were compared.Result(1)The postoperative LV of the patients showed a decreasing trend,and the liver function deteriorated in the short and medium term compared with that before operation.However,there were 14 patients with increased LV after operation.When comparing the liver function scores of patients with increased LV at 1st month,6th month and 1st year after operation with those before operation,it was found that: the liver function at 1st month and6 th month after surgery were compared with those before surgery(P < 0.05).Liver function at1 st year after surgery compared with the preoperative(P > 0.05).(2)Gastric and esophageal varices bleeding and ascites were improved after operation,but there was a high incidence of HE(26.8%).In group of patients with enlarged LV,the level of total bilirubin showed an increasing trend after surgery.The total bilirubin at 1st month after the operation was compared with that before the operation(P < 0.05),and the total bilirubin at 6th months and1 st year after operation was compared with that before the operation respectively(P > 0.05);The level of prothrombin time decreased after operation.The prothrombin time at 1st month,6th months and 1st year after operation were compared with that before operation respectively(P>0.05);The level of albumin showed an increased trend after surgery.The albumin at 1st month,6th months and 1st year after operation were compared with that before operation respectively(P<0.05).(3)By comparing the preoperative and postoperative LV of the patients under etiology,we found that: the preoperative LV and postoperative LV are different in patients with different etiologies(P<0.05).By comparison,the postoperative LV was not reduced significantly in non-viral HC patients.(4)Comparison of postoperative and preoperative LV of patients in different Child-Pugh grades,we found that: in the same Child-Pugh grades,the comparison of preoperative and postoperative LV of patients(P> 0.05);in the comparison of preoperative and postoperative LV of patients in different Child-Pugh grades(P < 0.05).(5)Comparison of clinical data between the postoperative LV enlargement group and LV reduction group:there were more patients with non-viral HC in the LV enlargement group,and there were more patients with viral HC in the LV reduction group(P< 0.05).Conclusion(1)The patient’s LV was reduced and the liver function was worse in the short and medium term after surgery.But,the Postoperative LV of 14 patients(25%)increased,especially in non-viral HC patients,although the liver function worsened in the short term after operation,but there was no significant change in liver function at 1 year after operation.(2)TIPS can significantly improve bleeding and ascites,and improve the quality of life of HC patients.