Safety and efficacy of TACE combined with TIPS for treating primary hepatic carcinoma complicating liver cirrhosis portal hypertension / 重庆医学

ABSTRACT

Objective To evaluate the safety and efficacy of transcatheter arterial chemoembolization (TACE) combined with transjugular intrahepatic portosystemic shunt (TIPS) in the patients with primary liver cancer complicating cirrhosis portal hypertension.Methods Twenty-two cases of TACE combined with TIPS due to decompensation of liver cancer complicating cirrhosis portal hypertension in this hospital from January 2011 to January 2015 were collected as the combined group and 28 cases of liver cancer complicating cirrhosis portal hypertension treated only by TACE without conducting TIPS were screened out as the control group.The curative effect and prognosis of the two groups were observed.Results The success rate of TIPS was 100％,the preoperative portal pressure was (38.4±7.6) cm H2O and the postoperative portal pressure was (28.4±7.7)cm H2O,the difference was statistically significant (P＜ 0.05);the preoperative portal vein diameter was (16.2 ±2.5)mm and postoperative portal vein diameter was (13.3±1.8)mm,the difference was statistically significant (P＜0.05).The postoperative 1-year stent patency rate was 95％ and 2-year stent patency rate was 90％.The postoperative 1-year and 2-year re-bleeding rates in the control group were 60.7 ％ and 78.5 ％ respectively,which in the combined group were 9.1％ and 13.6 ％ respectively,the differences were statistically significant (P＜0.05).The 1-year accumulated survival rate in the combined group was 81％,2-year accumulated survival rate was 68％,and the median survival time was 53 months,while the 1-year accumulated survival rate in the control group was 78 ％,2-year accumulated survival rate was 15 ％,and the median survival time was 17 months,the differences were statistically significant (P＜0.05).Conclusion Conducting TACE combined with TIPS in the patients with primary liver cancer complicating cirrhosis portal hypertension can safely and effectively control the tumor development,reduce and even eliminate the portal hypertension syndrome,and increase the life quality and survival rate.