Efficacy of transjugular intrahepatic portosystemic shunt combined with gastroesophageal variceal embolization in the treatment of 18 cases of gastric fundal varices associated with a gastrorenal shunt / 中华消化杂志

ABSTRACT

Objective To evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) combined with gastroesophageal variceal embolization (SEVE) in the treatment of patients with gastroesophageal varices accompanied by a gastrorenal shunt with a diameter over 5 mm .Methods From October 2013 to December 2014 ,the clinical data of 18 patients with portal hypertension caused gastroesophageal variceal bleeding and treated by TIPS combined with SEVE were collected . The difference of portosystemic pressure gradient between before and after operation was observed ,and Child‐Pugh score before and after operation was also evaluated .The hemostasis in 24 hours ,TIPS patency ,the occurrence of hepatic encephalopathy(HE) ,rebleeding ,hepatic failure ,mortality and the change of liver function and thrombocytopenia were recorded after operation .Student′s t‐test or analysis of variance was performed for statistical analysis of measurement data .Results In the 18 patients ,the average portal vein pressure decreased from (34 .23 ± 6 .35) cmH2O (1 cmH2O= 0 .098 kPa) before operation to (25 .69 ± 6 .89) cmH2O after TIPS combined with SEVE ,and the difference was statistically significant (t=7 .572 , P0 .05) .Conclusion TIPS combined with SEVE in the treatment of patients with gastroesophageal varices accompanied by a gastrorenal shunt with a diameter over 5 mm could effectively control bleeding ,and no ectopic embolism happened .