Combination of TIPSS and azygoportal disconnection for portal hypertension / 介入放射学杂志

ABSTRACT

Objective To investigate the clinical results of combined TIPSS and azygoportal disconnection for portal hypertension in controlling and preventing esophageal variceal bleeding. Methods From Oct. 1996 to Dec. 2001, 60 patients with portal hypertension were admitted to our department because of variceal bleeding and submitted to the treatment with the combination TIPSS and azygoportal disconnection. According to Child Pugh classification, 11 patients were in class A, 37 in class B, and 12 in class C. 41 patients showed mild ascites and 8 with severe ascites. The mild and severe esophageal varices were proven by upper digestive barium meal. The procedure was divided into two stages; first, TIPSS procedure with the stent of diameter 0.8cm and length 6-7cm was successfully inplanted in all patients, second, all patients underwent azygoportal disconnection two weeks later after TIPSS. Results After the combination TIPSS and azygoportal disconnection, the recent complications included three cases with bleeding at operative fields, one case with infradiaphagmatic abscess and seven with slight encephalopathy. No rebleeding of esophageal varices and death occurred during the treatment. During the follow up of 1-5 years, the rates of shunt occlusion, rebleeding and death were 11.9%, 3.5% and 7.0% respectively. Conclusions The combination TIPSS and azygoportal disconnection is an efficient therapeutic methods for portal hypertension.