Relationship between pre-transjugular intrahepatic portosystemic stent shunt(TIPS) hepatic hemodynamics and incidence of post-TIPS hepatic encephalopathy / 中华超声影像学杂志

ABSTRACT

Objective To study the relationship between pre transjugular intrahepatic portosystemic shunt(TIPS) liver hemodynamics and the incidence of post TIPS hepatic encephalopathy(HE).Methods Hepatic blood dynamics was evaluated in 41 cases of liver cirrhosis before TIPS and one month later.The patients were divided into two groups according to Doppler findings before TIPS.Group 1 composed of patients with prograde portal flow,group 2 composed of patients with hepatofugal or back forth portal flow.The clinical characteristics,incidence of post TIPS HE and pre/post TIPS hepatic arterial resistant index(RI) of the groups were compared.The independent prognostic value of pre TIPS variables for the onset of HE after TIPS was tested with a multiple regression analysis.The variables included age,pugh score,presence of HE before TIPS,the pattern of portal flow.Results The two groups did not differ significantly in their age,etiology of liver disease,indications of TIPS placement, HE incidence before TIPS and portacaval gradient before and after TIPS.But liver failure was more severe in group 2(P