Changes in liver and spleen stiffness after transjugular intrahepatic portosystemic shunt and their relationship with prognosis

doi:10.4240/wjgs.v17.i8.109884

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 17, Issue 8

This Article

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Supplementary Materials of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (2387)

All Articles published online

The chart showing PDF series, HTML series, Figures (1-5) series, Tables (1-2) series.

Item

Count

PDF

HTML

1339

Figures (1-5)

135

Tables (1-2)

130

Sum=1662

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

208

Download

451

Sum=659

Aug 27, 2025 (publication date) through Feb 18, 2026

Times Cited of This Article

Times Cited (0)

Journal Information of This Article

Publication Name

World Journal of Gastrointestinal Surgery

ISSN

1948-9366

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

World J Gastrointest Surg. Aug 27, 2025; 17(8): 109884
Published online Aug 27, 2025. doi: 10.4240/wjgs.v17.i8.109884

Changes in liver and spleen stiffness after transjugular intrahepatic portosystemic shunt and their relationship with prognosis

Xiao-Fang Liu, Xiao-Chun Huang, Qian-Jun Ye, Li-Jing Yuan, Gui-Fang Gao, Jin-Yu Li, Dui-Ping Feng

Xiao-Fang Liu, Xiao-Chun Huang, Qian-Jun Ye, Li-Jing Yuan, Gui-Fang Gao, Department of Ultrasound, First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China

Jin-Yu Li, Dui-Ping Feng, Department of Oncological and Vascular Intervention, First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China

Co-corresponding authors: Jin-Yu Li and Dui-Ping Feng.

Author contributions: Liu XF performed research design, draft the manuscript and data analysis; Huang XC draft the manuscript, performed the data collection and performed the statistical analysis; Ye QJ performed the statistical analysis and patient follow-up; Yuan LJ performed the data collection and management; Gao GF performed patient follow-up; Li JY and Feng DP performed research design, helped to draft the manuscript and analytical guidance. All authors have read and approve the final manuscript. Li JY and Feng DP contributed equally to the work and should be regarded as co-corresponding authors. In contemporary academic research, designating two co-corresponding authors is increasingly recognized as a valid and often necessary practice, reflecting the complex and collaborative nature of scientific inquiry. The primary justification lies in accurately representing substantial, distinct, and indispensable contributions to both the project's execution and its communication. Many projects exhibit complementary expertise domains where leadership is genuinely shared. This study represents a collaborative achievement between the fields of ultrasound imaging and interventional medicine, necessitating the allocation of professional tasks by two corresponding authors. Feng DP, an expert in interventional medicine, is responsible for that aspect of the work, while Li JY oversees the ultrasound medicine component. Designating both individuals as corresponding authors clearly indicates their equitable partnership and shared responsibility for the integrity of the work, future correspondence, data oversight, and accountability. This approach transcends traditional single-correspondent models, which might otherwise obscure the true dynamics of collaborative leadership essential for large-scale, interdisciplinary projects. This practice is in line with evolving guidelines, such as those from the ICMJE, which emphasize the importance of substantial contributions, and ensures that authorship fairly reflects the intellectual and logistical leadership that underpins the research.

Supported by National Natural Science Foundation of China, No. 82200650; Shanxi Provincial Clinical Research Center for Interventional Medicine, No. 202204010501004; the Precision Interventional Diagnosis and Treatment Technology Innovation Base for Cirrhosis and Portal Hypertension, No. YDZJSX20231B010; the Natural Science Foundation of Shanxi Province, No. 20210302124282 and No. 202203021212046; the Shanxi Province Higher Education “Billion Project Science and Technology Guidance Project”, No. 2C622024120; and the National Natural Science Foundation of China Supporting Fund, No. Y82200650.

Institutional review board statement: The Institutional Review Board of First Hospital of Shanxi Medical University approved this study (Approval No. K-K112).

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: Data can be acquired from the corresponding author.

Corresponding author: Dui-Ping Feng, Chief Physician, Department of Oncological and Vascular Intervention, First Hospital of Shanxi Medical University, No. 85 Jiefang South Road, Yingze District, Taiyuan 030001, Shanxi Province, China. fengdp@sxmu.edu.cn

Received: May 26, 2025
Revised: June 17, 2025
Accepted: July 14, 2025
Published online: August 27, 2025
Processing time: 93 Days and 9.3 Hours

Abstract

BACKGROUND

The impact of transjugular intrahepatic portosystemic shunt (TIPS) on liver and spleen stiffness remains unclear, as does the association between preoperative liver and spleen stiffness and prognosis following TIPS.

AIM

To investigate changes in liver and spleen stiffness after TIPS and examines the relationship between these parameters and the prognosis of post-TIPS patients.

METHODS

A total of 76 patients with liver cirrhosis and portal hypertension who underwent TIPS were included. Liver and spleen stiffness was assessed using the sound touch quantify (STQ) value, determined via point shear wave elastography in ultrasound imaging. Cox regression analysis was employed to evaluate the relationship between liver and spleen stiffness and cumulative survival in TIPS patients.

RESULTS

The liver STQ value demonstrated a marginally decreasing trend over time (P = 0.052), while the spleen STQ value showed a significantly decreasing trend (P = 0.025). Spleen STQ was positively correlated with portal pressure gradient (PPG) levels (r_s = 0.327, P = 0.025). Cox regression analysis indicated that older age [hazard ratio (HR) = 1.063, 95%CI: 0.997-1.133, P = 0.060] and a higher liver STQ value (HR = 1.051, 95%CI: 1.009-1.095, P = 0.018) were associated with an increased mortality risk after TIPS. No significant correlation was found between liver or spleen stiffness and overt hepatic encephalopathy post-TIPS. The liver STQ value [area under the receiver operating characteristic curve (AUC) = 0.724 (95%CI: 0.563-0.884)] showed superior predictive performance compared to the Child-Pugh score [AUC = 0.699 (95%CI: 0.529-0.870)] and was comparable to the model for end-stage liver disease score [AUC = 0.746 (95%CI: 0.591-0.902)].

CONCLUSION

Following TIPS, spleen stiffness exhibited a more pronounced change than liver stiffness and was positively associated with PPG. Preoperative liver stiffness serves as a prognostic indicator for survival in patients undergoing TIPS.

Keywords: Liver and spleen stiffness; Sound touch quantify; Portal pressure gradient; Transjugular intrahepatic portosystemic shunt; Prognosis

Core Tip: This study involved 76 patients with liver cirrhosis who underwent a transjugular intrahepatic portosystemic shunt (TIPS). The stiffness of the liver and spleen was assessed using point shear wave elastography with ultrasonic imaging, which quantifies the sound touch value. The results indicated that spleen stiffness significantly decreased over time following TIPS. Older age and higher liver stiffness were correlated with an elevated risk of mortality following TIPS. In summary, following TIPS, spleen stiffness exhibited a more pronounced change than liver stiffness. Preoperative liver stiffness serves as a prognostic indicator for survival in patients undergoing TIPS.