ABSTRACT
Objective To investigate the influence of the stent position in transjugular intrahepatic left branch of portal vein portosystemic shunt (TILPS) on the long-term effect.Methods The clinical data of 527 patients with upper gastrointestinal bleeding duo to portal hypertension,who were treated with TILPS during the the period from January 2012 to December 2014,were retrospectively analyzed.According to whether the stent was placed into the left branch of portal vein,the patients were divided into the study group (stent in the left branch of portal vein,n=318) and the control group (stent in the main portal vein,n=209).The success rate of surgery,the shunt channel flow dynamics,the stent patency rate,the incidence of hepatic encephalopathy,the rate of re-bleeding,etc.were compared between the two groups.Results The success rate of shunting operation was 100％ in both groups.One year after the treatment,the blood velocity and flow parameters in the shunt channel of the study group were significantly higher than those of the control group (P＜0.05).During the the follow-up period lasting for one year,the incidences of shunt channel dysfunction in the study group and in the control group were 1.26％ (4/318) and 5.74％ (12/209) respectively (P=0.003),the incidences of hepatic encephalopathy in the study group and in the control group were 0.31％ (1/318) and 4.31％ (9/209) respectively (P=0.001),and the incidences of re-bleeding in the study group and in the control group were 0.94％ (3/318) and 2.87％ (6/209) respectively (P=0.095).Conclusion During the performance of TIPS,the puncture of the left branch of portal vein and placement of the stent in the left branch of portal vein can reduce both the incidence of shunt channel dysfunction and the incidence of hepatic encephalopathy.