Li XY, Li Y, Li WQ, Ju S, Dong ZH, Luo JJ. Enhancing transjugular intrahepatic portosystemic shunt procedure efficiency with digital subtraction angiography image overlay technology in esophagogastric variceal bleeding. World J Gastrointest Surg 2024; 16(9): 2870-2877 [PMID: 39351548 DOI: 10.4240/wjgs.v16.i9.2870]
Corresponding Author of This Article
Shuai Ju, MD, Doctor, Vascular and Wound Center, Jinshan Hospital, Fudan University, No. 1508 Longhang Road, Shanghai 201508, China. jushuai19881003@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Sep 27, 2024; 16(9): 2870-2877 Published online Sep 27, 2024. doi: 10.4240/wjgs.v16.i9.2870
Enhancing transjugular intrahepatic portosystemic shunt procedure efficiency with digital subtraction angiography image overlay technology in esophagogastric variceal bleeding
Xiao-Yan Li, Yao Li, Wen-Qiang Li, Shuai Ju, Zhi-Hui Dong, Jian-Jun Luo
Xiao-Yan Li, Yao Li, Wen-Qiang Li, Shuai Ju, Vascular and Wound Center, Jinshan Hospital, Fudan University, Shanghai 201508, China
Zhi-Hui Dong, Department of Vascular Surgery, Institute of Vascular Surgery, Zhongshan Hospital Fudan University, Shanghai 200032, China
Jian-Jun Luo, Department of Interventional Radiology, Zhongshan Hospital Fudan University, Shanghai 20032, China
Author contributions: Ju S designed the research study; Ju S, Li Y, Li WQ, and Li XY performed the research; Dong ZH and Luo JJ provided help and advice on the acquisition of data; Ju S analyzed the data; Li XY wrote the draft manuscript; Ju S, Dong ZH, and Luo JJ interpreted the data for the work, revised the manuscript, and approved the final version.
Supported byJinshan Science and Technology Committee (the data collection for this study was partially funded by the project), No. 2021-3-05.
Institutional review board statement: This study was conducted in accordance with the Declaration of Helsinki and received approval from the Institutional Review Board of Jinshan Hospital, Fudan University (No. JIEC 2023-S52).
Informed consent statement: Informed consent was obtained from each participant, ensuring adherence to ethical standards and relevant guidelines and regulations.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Data are available upon request from the corresponding author at jushuai19881003@163.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Received: May 19, 2024 Revised: June 29, 2024 Accepted: July 31, 2024 Published online: September 27, 2024 Processing time: 122 Days and 11.7 Hours
Abstract
BACKGROUND
Transjugular intrahepatic portosystemic shunt (TIPS) is a pivotal intervention for managing esophagogastric variceal bleeding in patients with chronic hepatic schistosomiasis.
AIM
To evaluate the efficacy of digital subtraction angiography image overlay technology (DIT) in guiding the TIPS procedure.
METHODS
We conducted a retrospective analysis of patients who underwent TIPS at our hospital, comparing outcomes between an ultrasound-guided group and a DIT-guided group. Our analysis focused on the duration of the portosystemic shunt puncture, the number of punctures needed, the total surgical time, and various clinical indicators related to the surgery.
RESULTS
The study included 52 patients with esophagogastric varices due to chronic hepatic schistosomiasis. Results demonstrated that the DIT-guided group experienced significantly shorter puncture times (P < 0.001) and surgical durations (P = 0.022) compared to the ultrasound-guided group. Additionally, postoperative assessments showed significant reductions in aspartate aminotransferase, B-type natriuretic peptide, and portal vein pressure in both groups. Notably, the DIT-guided group also showed significant reductions in total bilirubin (P = 0.001) and alanine aminotransferase (P = 0.023).
CONCLUSION
The use of DIT for guiding TIPS procedures highlights its potential to enhance procedural efficiency and reduce surgical times in the treatment of esophagogastric variceal bleeding in patients with chronic hepatic schistosomiasis.
Core Tip: A comparison of procedural metrics between digital subtraction angiography image overlay technology (DIT)-guided and ultrasound-guided transjugular intrahepatic portosystemic shunt (TIPS). Demonstration of significant reductions in puncture time and surgical duration in the DIT-guided group. Improved clinical indicators post-procedure, including reductions in aspartate aminotransferase, B-type natriuretic peptide, and portal vein pressure in both groups, with additional benefits in total bilirubin and alanine aminotransferase levels in the DIT-guided group. Our research addresses a critical need for efficient and safer TIPS procedures in patients with complex hepatic anatomy due to chronic schistosomiasis, which underscores the potential of DIT as a superior guidance technology, providing a foundation for further advancements in interventional radiology techniques.
