Wu SZ, Liu GQ. Surgery-assisted transmesenteric transjugular intrahepatic portosystemic shunt for esophagogastric bleeding in patients with cavernous transformation of the portal vein. World J Gastrointest Surg 2026; 18(2): 114633 [DOI: 10.4240/wjgs.v18.i2.114633]
Corresponding Author of This Article
Si-Ze Wu, MD, Chief Physician, Professor, Department of Ultrasound, The First Affiliated Hospital of Hainan Medical University, No. 31 Longhua Road, Haikou 570102, Hainan Province, China. wsz074@aliyun.com
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Multidisciplinary Sciences
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Editorial
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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/
Feb 27, 2026 (publication date) through Feb 26, 2026
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World Journal of Gastrointestinal Surgery
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1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Wu SZ, Liu GQ. Surgery-assisted transmesenteric transjugular intrahepatic portosystemic shunt for esophagogastric bleeding in patients with cavernous transformation of the portal vein. World J Gastrointest Surg 2026; 18(2): 114633 [DOI: 10.4240/wjgs.v18.i2.114633]
World J Gastrointest Surg. Feb 27, 2026; 18(2): 114633 Published online Feb 27, 2026. doi: 10.4240/wjgs.v18.i2.114633
Surgery-assisted transmesenteric transjugular intrahepatic portosystemic shunt for esophagogastric bleeding in patients with cavernous transformation of the portal vein
Si-Ze Wu, Guang-Qing Liu
Si-Ze Wu, Guang-Qing Liu, Department of Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou 570102, Hainan Province, China
Author contributions: Wu SZ designed the concept of the manuscript, and critically revised the manuscript; Liu GQ wrote the manuscript. Both authors approved the final version to publish.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Si-Ze Wu, MD, Chief Physician, Professor, Department of Ultrasound, The First Affiliated Hospital of Hainan Medical University, No. 31 Longhua Road, Haikou 570102, Hainan Province, China. wsz074@aliyun.com
Received: September 24, 2025 Revised: November 6, 2025 Accepted: December 3, 2025 Published online: February 27, 2026 Processing time: 155 Days and 1.9 Hours
Abstract
This editorial provides commentary on the study by Wu et al, which investigates a novel intervention for a challenging clinical scenario: Transjugular intrahepatic portosystemic shunt (TIPS) placement with the assistance of surgery in patients with cavernous transformation of the portal vein. The authors compared surgically assisted TIPS (SATIPS) in 54 patients to endoscopic sclerotherapy in 53 patients. While 3-month survival rates were similar (94.4% vs 92.5%), a significant difference emerged at 6 months, with survival rates of 94.4% for SATIPS vs 73.6% for endoscope sclerotherapy. The SATIPS group also demonstrated significantly lower incidences of liver failure, esophagogastric bleeding, and hepatic encephalopathy at 6 months. However, the SATIPS procedure was not without risk, as four patients experienced major complications, including intraoperative hemorrhage. The study concludes that SATIPS is an effective alternative for cavernous transformation of the portal vein patients with esophagogastric bleeding, but its findings must be interpreted in light of its limitations. This research represents a significant contribution to the field.
Core Tip: This study suggests that for patients with cavernous transformation of the portal vein and esophagogastric bleeding, surgically assisted transjugular intrahepatic portosystemic shunt offers a survival advantage over endoscopic sclerotherapy at six months, with lower rates of liver failure, rebleeding, and hepatic encephalopathy. However, the surgically assisted transjugular intrahepatic portosystemic shunt carries a risk of serious complications, such as intraoperative hemorrhage and wound infection, which must be weighed against its benefits.
