Yao X, He S, Wei M, Qin JP. Influence of different portal vein branches on hepatic encephalopathy during intrahepatic portal shunt via jugular vein. World J Gastroenterol 2022; 28(31): 4467-4470 [PMID: 36159008 DOI: 10.3748/wjg.v28.i31.4467]
Corresponding Author of This Article
Jian-Ping Qin, MD, Chief Doctor, Doctor, Department of Gastroenterology, General Hospital of Western Theater Command, No. 270 Rongdu Road, Chengdu 610083, Sichuan Province, China. jpqqing@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Aug 21, 2022; 28(31): 4467-4470 Published online Aug 21, 2022. doi: 10.3748/wjg.v28.i31.4467
Influence of different portal vein branches on hepatic encephalopathy during intrahepatic portal shunt via jugular vein
Xin Yao, Sheng He, Meng Wei, Jian-Ping Qin
Xin Yao, Sheng He, Meng Wei, Jian-Ping Qin, Department of Gastroenterology, General Hospital of Western Theater Command, Chengdu 610083, Sichuan Province, China
Author contributions: All authors wrote and edited the manuscript.
Conflict-of-interest statement: The authors declare no competing interests for this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Ping Qin, MD, Chief Doctor, Doctor, Department of Gastroenterology, General Hospital of Western Theater Command, No. 270 Rongdu Road, Chengdu 610083, Sichuan Province, China. jpqqing@163.com
Received: February 11, 2022 Peer-review started: February 11, 2022 First decision: April 5, 2022 Revised: April 7, 2022 Accepted: July 22, 2022 Article in press: July 22, 2022 Published online: August 21, 2022
Abstract
This letter is regarding the study titled ‘Targeted puncture of left branch of intrahepatic portal vein in transjugular intrahepatic portosystemic shunt (TIPS) to reduce hepatic encephalopathy’. Prior to the approval of TIPS dedicated stents (Viatorr stents) in China in October 2015, Fluency covered stents were typically used. As Fluency covered stents have a strong support force and axial elastic tension, a ‘cap’ may form if the stent is located too low at the end of the hepatic vein or too short at the end of the portal vein during surgery, leading to stent dysfunction. Since the blood shunted by the stent is from the main trunk of the portal vein, the correlation between the incidence of postoperative hepatic encephalopathy and the location of the puncture target (left or right portal vein branch) is worth discussion. Notably, no studies in China or foreign countries have proven the occurrence of left and right blood stratification after the accumulation of splenic vein and mesenteric blood flow in the main trunk of the portal vein in patients with cirrhotic portal hypertension.
Core Tip: This Letter to the Editor aims to analyse the effect of establishing a shunt in the left or right portal vein branch in transjugular intrahepatic portosystemic shunt on the incidence of postoperative hepatic encephalopathy in patients with cirrhotic portal hypertension. Based on preliminary clinical experience, it is thought that there is no difference in the incidence of hepatic encephalopathy among patients regardless of the use of a COOK bare stent or Viatorr stent with an inner diameter of 8 mm if a shunt is established in the left or right portal vein branch.
