Transjugular intrahepatic portosystemic shunt for palliative treatment of portal hypertension secondary to portal vein tumor thrombosis

doi:10.3748/wjg.v10.i13.1881

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Liver Cancer

World J Gastroenterol. Jul 1, 2004; 10(13): 1881-1884
Published online Jul 1, 2004. doi: 10.3748/wjg.v10.i13.1881

Transjugular intrahepatic portosystemic shunt for palliative treatment of portal hypertension secondary to portal vein tumor thrombosis

Zai-Bo Jiang, Hong Shan, Xin-Ying Shen, Ming-Sheng Huang, Zheng-Ran Li, Kang-Shun Zhu, Shou-Hai Guan

Zai-Bo Jiang, Hong Shan, Xin-Ying Shen, Ming-Sheng Huang, Zheng-Ran Li, Kang-Shun Zhu, Shou-Hai Guan, Department of Radiology, the 3rd Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China

Author contributions: All authors contributed equally to the work.

Correspondence to: Dr. Hong Shan, the 3rd Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China. jzb01@163.net

Telephone: +86-20-85516867 Fax: +86-20-87580725

Received: December 28, 2003
Revised: January 1, 2004
Accepted: January 8, 2004
Published online: July 1, 2004

Abstract

AIM: To evaluate the palliative therapeutic effects of transjugular intrahepatic portosystemic shunt (TIPS) in portal vein tumor thrombosis (PVTT) complicated by portal hypertension.

METHODS: We performed TIPS for 14 patients with PVTT due to hepatocellular carcinoma (HCC). Of the 14 patients, 8 patients had complete occlusion of the main portal vein, 6 patients had incomplete thrombosis, and 5 patients had portal vein cavernous transformation. Clinical characteristics and average survial time of 14 patients were analysed. Portal vein pressure, ascites, diarrohea, and variceal bleeding and circumference of abdomen were assessed before and after TIPS.

RESULTS: TIPS was successful in 10 cases, and the successful rate was about 71%. The mean portal vein pressure was reduced from 37.2 mmHg to 18.2 mmHg. After TIPS, the ascites decreased, hemorrhage stopped and the clinical symptoms disappeared in the 10 cases. The average survial time was 132.3 d. The procedure failed in 4 cases because of cavernous transformation in portal vein and severe cirrhosis.

CONCLUSION: TIPS is an effective palliative treatment to control hemorrhage and ascites due to HCC complicated by PVTT.

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