Clinical effects and complications of TIPS for portal hypertension due to cirrhosis: A single center

Table 1 Clinical data on transjugular intrahepatic portosystemic shunt in 280 patients

Clinical factor	No. of patients
Sex
Male	223
Female	57
Age (yr, mean ± SD)	48.2 ± 13.7
Procedure
Elective	260
Emergency	20
Indication for TIPS
Hemorrhage of upper digestive tract	265
Hepatorenal syndrome	15
Cause
Cirrhosis after hepatitis B virus infection	168
Cirrhosis after hepatitis C virus infection	10
Hepatatis B virus infection complicated by schistosomial cirrhosis	16
Hepatitis B virus infection complicated by alcoholic cirrhosis	54
Alcoholic cirrhosis	24
Unexplained cirrhosis	8
Child-Pugh grading
A	60
B	184
C	36

TIPS: Transjugular intrahepatic portosystemic shunt.

Table 2 Changes in dynamics and diameters of blood vessels before and after transjugular intrahepatic portosystemic shunt (n = 278, mean ± SD)

	Preoperative	Postoperative	P value
Portal venous pressure (cmH2O)	46.5 ± 3.4	26.8 ± 3.6	< 0.001
Portal venous internal diameter (cm)	1.68 ± 0.15	1.32 ± 0.11	0.007
Splenic venous internal diameter (cm)	1.31 ± 0.05	1.12 ± 0.03	0.009
Blood velocity in the portal vein (cm/s)	15.2 ± 4.7	49.3 ± 18.5	< 0.001
Blood velocity in the shunt pathway (cm/s)		154.0 ± 32.6

All parameters shown in Table 1 were significantly different before and after surgery (P < 0.01).

Table 3 Changes in liver function and prothrombin time before and after transjugular intrahepatic portosystemic shunt (n = 278, mean ± SD)

TIPS	ALT	TBIL	Alb	PT
	(IU/L)	(μmol/L)	(g/L)	(s)
1 wk before TIPS	40.78 ± 5.41	29.33 ± 5.97	32.49 ± 5.14	13.43 ± 1.44
1 mo after TIPS	42.26 ± 2.32	28.45 ± 8.71	33.25 ± 4.18	17.73 ± 1.83a
P value	0.679	0.813	0.716	0.036

^aP < 0.05 vs the preoperative data. ALT: Alanine aminotransferase; TBIL: Total bilirubin; Alb: Albumin; PT: Prothrombin time; TIPS: Transjugular intrahepatic portosystemic shunt.

Table 4 Complications of transjugular intrahepatic portosystemic shunt (n = 280) n (%)

Complication
Intraoperative
Abdominal cavity hemorrhage	2 (0.7)
Puncture of biliary tract	10 (3.6)
Puncture of gallbladder	5 (1.8)
Puncture of hepatic artery	8 (2.9)
Puncture of hepatic capsule	18 (6.4)
Heterotopic embolism	4 (1.4)
Displacement of stent	6 (2.1)
Short-term after TIPS (1 mo)
Abdominal cavity hemorrhage	2 (0.7)
Hepatic failure	20 (7.2)
Hemorrhagic ascites	7 (2.5)
Hemorrhage of digestive tract	4 (1.4)
Septicemia	3 (1.1)
Hemolysis	8 (2.9)
Hyperglycemia	4 (1.4)
Hemobilia	2 (0.7)
Subcapsular hematoma of liver	3 (1.1)
Puffiness of face	2 (0.7)
Long-term after TIPS (> 1 mo) cumulative incidence
Stent abnormality
12 mo	24%
24 mo	34%
Hepatic encephalopathy
3 mo	14%
6 mo	18%
12 mo	19%

TIPS: Transjugular intrahepatic portosystemic shunt.