Copyright
©The Author(s) 2020.
World J Gastroenterol. Jun 28, 2020; 26(24): 3472-3483
Published online Jun 28, 2020. doi: 10.3748/wjg.v26.i24.3472
Published online Jun 28, 2020. doi: 10.3748/wjg.v26.i24.3472
Table 1 Baseline clinical characteristics of the patients in the two groups
Characteristic | TIPS group (n = 37) | Conservative treatment group (n = 17) | P value |
Gender (male/female) | 28/9 | 11/6 | 0.403 |
Age (yr) | 62.30 ± 10.91 | 60.18 ± 15.37 | 0.563 |
Onset-to-treatment time (d) | 28.57 ± 15.26 | 26.18 ± 12.44 | 0.535 |
MELD score | 12.13 ± 5.32 | 12.76 ± 4.96 | 0.683 |
Early therapeutic regimen | |||
Reduced glutathione | 37 (100) | 17 (100) | NA |
Ademetionine | 37 (100) | 17 (100) | NA |
Diuretics | 37 (100) | 17 (100) | NA |
Low molecular weight heparin | 37 (100) | 17 (100) | NA |
Glucocorticoids | 11 (29.73) | 6 (35.29) | 0.757 |
Antibacterial drugs, | 23 (62.16) | 12 (70.60) | 0.549 |
Clinical symptoms on admission | |||
Ascites (yes/no) | 37/0 | 17/0 | NA |
Hepatomegaly (yes/no) | 26/11 | 10/7 | 0.407 |
Hepatalgia (yes/no) | 15/22 | 7/10 | 0.965 |
Peritonitis (yes/no) | 7/30 | 2/15 | 0.512 |
Loss of appetite (yes/no) | 34/3 | 15/2 | 0.667 |
Gastrointestinal bleeding (yes/no) | 1/36 | 0/17 | 0.494 |
Weight gain (yes/no) | 12/25 | 6/11 | 0.836 |
Laboratory indicators at 2 wk | |||
Total bilirubin (μmol/L) | 53.3 (39.8) | 53.6 (45.0) | 0.904 |
Direct bilirubin (μmol/L) | 32.4 (32.6) | 37.4 (47.0) | 0.520 |
Alanine transaminase (U/L) | 45.0 (69.0) | 55.0 (86.0) | 0.342 |
Aspartate transaminase (U/L) | 65.0 (48.0) | 62.0 (89.0) | 0.628 |
Gamma-glutamyl transferase (U/L) | 125.0 (90.0) | 91.0 (94.0) | 0.099 |
Alkaline phosphatase (U/L) | 112.6 (60.0) | 95.0 (91.0) | 0.087 |
Albumin (g/L) | 31.32 ± 3.38 | 31.95 ± 4.92 | 0.588 |
Prothrombin time (s) | 15.81 ± 3.64 | 16.75 ± 2.28 | 0.342 |
White blood cell count (109/L) | 6.75 ± 3.05 | 6.66 ± 2.20 | 0.913 |
Neutrophil proportion (%) | 64.19 ± 12.16 | 64.39 ± 10.70 | 0.955 |
Red blood cell count (1012/L) | 4.91 ± 0.81 | 4.49 ± 0.63 | 0.064 |
Platelet count (109/L) | 108.0 (49.0) | 90.0 (68.0) | 0.165 |
Blood urea nitrogen (mmol/L) | 6.8 (3.4) | 5.6 (4.3) | 0.252 |
Creatinine (μmol/L) | 67.6 (32.0) | 75.0 (35.0) | 0.780 |
Maximum depth of ascites (mm) | 95.22 ± 22.58 | 81.65 ± 26.29 | 0.057 |
Table 2 Results of liver function tests for patients in the two groups
Group and time point | TBil (μmol/L) | DBil (μmol/L) | ALT (U/L) | AST (U/L) |
TIPS group | ||||
Before treatment (n = 37) | 53.30 (39.80) | 32.40 (32.60) | 45.00 (69.00) | 65.00 (48.00) |
1 wk after treatment (n = 36) | 60.20 (70.60) | 44.85 (49.43) | 40.50 (53.00) | 59.00 (65.00) |
2 wk after treatment (n = 35) | 56.40 (30.40) | 35.20 (28.40) | 36.00 (26.00) | 47.00 (17.00)a |
1 mo after treatment (n = 35) | 47.20 (13.70)c | 29.20 (14.10)c | 26.00 (20.00)ace | 40.00 (16.00)ac |
3 mo after treatment (n = 35) | 44.20 (9.70)c | 27.40 (13.10)c | 31.00 (11.00) | 41.00 (12.00)ac |
P value | < 0.05 | < 0.05 | < 0.05 | < 0.05 |
Conservative treatment group | ||||
Before treatment (n = 17) | 53.60 (45.00) | 37.40 (47.00) | 55.00 (86.0) | 62.00 (89.00) |
1 wk after treatment (n = 17) | 67.80 (41.60) | 43.60 (35.95) | 56.00 (99.00) | 67.00 (109.00) |
2 wk after treatment (n = 16) | 52.25 (71.30) | 37.60 (60.30) | 44.00 (42.00) | 53.50 (44.00) |
1 mo after treatment (n = 16) | 44.40 (39.24) | 31.20 (31.80) | 34.50 (44.00) | 41.50 (50.00) |
3 mo after treatment (n = 12) | 38.15 (37.95) | 26.00 (35.80) | 25.00 (55.00) | 39.00 (64.00) |
P value | > 0.05 | > 0.05 | > 0.05 | > 0.05 |
Table 3 Results of ascites depth for patients in the two groups
Group and time point | Ascites depth (mm) |
TIPS group | |
Before treatment (n = 37) | 95 (30) |
1 wk after treatment (n = 36) | 35 (35)c |
2 wk after treatment (n = 35) | 0 (13)ac |
1 mo after treatment (n = 35) | 0 (0)ac |
3 mo after treatment (n = 35) | 0 (0)ac |
P value | < 0.001 |
Conservative treatment group | |
Before treatment (n = 17) | 85 (20) |
1 wk after treatment (n = 17) | 71 (34) |
2 wk after treatment (n = 16) | 69.5 (37) |
1 mo after treatment (n = 16) | 56.5 (53) |
3 mo after treatment (n = 12) | 31 (74) |
P value | 0.158 |
Table 4 Comparison of treatment outcomes between the two groups during follow up
Outcome | TIPS group (n = 37) | Conservative treatment group (n = 17) | P value |
Spontaneous peritonitis (yes/no) | 3/34 | 9/8 | < 0.001 |
Pyemia (yes/no) | 1/36 | 4/13 | 0.014 |
Liver failure (yes/no) | 3/34 | 6/11 | 0.013 |
Gastrointestinal bleeding (yes/no) | 0/37 | 1/16 | 0.136 |
Multiple organ failure (yes/no) | 0/37 | 2/15 | 0.033 |
Hepatic encephalopathy (yes/no) | 8/29 | 1/16 | 0.149 |
Main portal vein thrombosis (yes/no) | 0/37 | 1/16 | 0.136 |
Intraoperative bleeding (yes/no) | 1/36 | 0/2 | 0.814 |
Stenosis of shunt channel (yes/no) | 0/37 | 0/2 | NA |
Attributable deaths (death/survival) | 2/35 | 7/10 | 0.001 |
Cause of death | |||
Pyemia (yes/no) | 1/36 | 3/14 | 0.051 |
Liver failure (yes/no) | 1/36 | 2/15 | 0.177 |
Gastrointestinal bleeding (yes/no) | 0/37 | 1/16 | 0.136 |
Multiple organ failure (yes/no) | 0/37 | 2/15 | 0.033 |
- Citation: Zhou CZ, Wang RF, Lv WF, Fu YQ, Cheng DL, Zhu YJ, Hou CL, Ye XJ. Transjugular intrahepatic portosystemic shunt for pyrrolizidine alkaloid-related hepatic sinusoidal obstruction syndrome. World J Gastroenterol 2020; 26(24): 3472-3483
- URL: https://www.wjgnet.com/1007-9327/full/v26/i24/3472.htm
- DOI: https://dx.doi.org/10.3748/wjg.v26.i24.3472