A. Shabunin, V. Bedin, P. Drozdov, O. N. Levina, V. Tsurkan, O. S. Zhuravel
{"title":"多学科医院肝移植项目经颈静脉肝内门静脉系统分流术的首次经验","authors":"A. Shabunin, V. Bedin, P. Drozdov, O. N. Levina, V. Tsurkan, O. S. Zhuravel","doi":"10.16931/1995-5464.2022-1-48-55","DOIUrl":null,"url":null,"abstract":"Aim: Analysis of the first experience of transjugular intrahepatic portosystemic shunting (TIPS) in patients with liver cirrhosis at a multidisciplinary hospital with a liver transplantation program.Materials and methods: The authors examined 206 patients with liver cirrhosis from July 2019 to June 2021, with 20 of them undergoing TIPS. The mean age of the patients was 47.59 ± 9.55 years (35–65 years). Dynamic follow-up was performed at 3, 6, 9, 12, and 18 months. As a part of the dynamic follow-up, the patients underwent laboratory tests, abdomen ultrasound examination, and computed tomography imaging enhanced by the intravenous use of contrasting agent, endoscopy, esophagogastroduodenoscopy, and encephalopathy assessment.Results: No in-hospital TIPS-associated mortality has been reported. Two patients died in the hospital at the 19th and 26th day following the surgery because of the progression of liver failure, the 6-week mortality rate was 10%. In one patient (5%), an intraoperative complication was reported, i.e., intra-abdominal hemorrhage secondary to the migration of the stent under the liver capsule. The length of hospital stay after surgery was 7.34 ± 1.89 days (5–26 days). Long-term outcomes were available for 17 patients. The duration of the dynamic follow-up was 13.23 ± 2.47 months (3–24 months) and 2 (11,7%) deaths were reported. One patient (5.8%) was diagnosed with a shunt thrombosis at 12 months after the surgery. Three patients underwent liver transplantation after TIPS. The current one-year survival rate is 90%.Conclusion: TIPS is a safe and effective procedure decreasing mortality and improving quality of life of patients awaiting cadaveric liver transplantation. TIPS should be widely implemented in multidisciplinary hospitals having liver transplant program.","PeriodicalId":36549,"journal":{"name":"Annals of HPB Surgery","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"First experience of transjugular intrahepatic portosystemic shunting at multidisciplinary hospital with a liver transplantation program\",\"authors\":\"A. Shabunin, V. Bedin, P. Drozdov, O. N. Levina, V. Tsurkan, O. S. Zhuravel\",\"doi\":\"10.16931/1995-5464.2022-1-48-55\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Aim: Analysis of the first experience of transjugular intrahepatic portosystemic shunting (TIPS) in patients with liver cirrhosis at a multidisciplinary hospital with a liver transplantation program.Materials and methods: The authors examined 206 patients with liver cirrhosis from July 2019 to June 2021, with 20 of them undergoing TIPS. The mean age of the patients was 47.59 ± 9.55 years (35–65 years). Dynamic follow-up was performed at 3, 6, 9, 12, and 18 months. As a part of the dynamic follow-up, the patients underwent laboratory tests, abdomen ultrasound examination, and computed tomography imaging enhanced by the intravenous use of contrasting agent, endoscopy, esophagogastroduodenoscopy, and encephalopathy assessment.Results: No in-hospital TIPS-associated mortality has been reported. Two patients died in the hospital at the 19th and 26th day following the surgery because of the progression of liver failure, the 6-week mortality rate was 10%. In one patient (5%), an intraoperative complication was reported, i.e., intra-abdominal hemorrhage secondary to the migration of the stent under the liver capsule. The length of hospital stay after surgery was 7.34 ± 1.89 days (5–26 days). Long-term outcomes were available for 17 patients. The duration of the dynamic follow-up was 13.23 ± 2.47 months (3–24 months) and 2 (11,7%) deaths were reported. One patient (5.8%) was diagnosed with a shunt thrombosis at 12 months after the surgery. Three patients underwent liver transplantation after TIPS. The current one-year survival rate is 90%.Conclusion: TIPS is a safe and effective procedure decreasing mortality and improving quality of life of patients awaiting cadaveric liver transplantation. TIPS should be widely implemented in multidisciplinary hospitals having liver transplant program.\",\"PeriodicalId\":36549,\"journal\":{\"name\":\"Annals of HPB Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-02-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of HPB Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.16931/1995-5464.2022-1-48-55\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of HPB Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.16931/1995-5464.2022-1-48-55","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 1
摘要
目的:分析多学科医院肝移植项目肝硬化患者经颈静脉肝内门静脉系统分流术(TIPS)的首次经验。材料和方法:作者在2019年7月至2021年6月期间检查了206例肝硬化患者,其中20例接受了TIPS治疗。患者平均年龄为47.59±9.55岁(35 ~ 65岁)。分别在3、6、9、12和18个月进行动态随访。作为动态随访的一部分,患者接受了实验室检查、腹部超声检查、通过静脉使用造影剂增强的计算机断层扫描成像、内窥镜检查、食管胃十二指肠镜检查和脑病评估。结果:没有与tips相关的住院死亡率报告。2例患者术后第19天和第26天因肝功能衰竭进展在医院死亡,6周死亡率为10%。1例患者(5%)报告术中并发症,即肝包膜下支架迁移继发腹腔出血。术后住院时间为7.34±1.89 d (5 ~ 26 d)。17例患者获得了长期结果。动态随访时间为13.23±2.47个月(3 ~ 24个月),死亡2例(11.7%)。1例患者(5.8%)在术后12个月被诊断为分流血栓形成。3例患者行肝移植手术。目前的一年生存率为90%。结论:TIPS是一种安全有效的方法,可降低尸体肝移植患者的死亡率,提高患者的生活质量。TIPS应广泛应用于有肝移植项目的多学科医院。
First experience of transjugular intrahepatic portosystemic shunting at multidisciplinary hospital with a liver transplantation program
Aim: Analysis of the first experience of transjugular intrahepatic portosystemic shunting (TIPS) in patients with liver cirrhosis at a multidisciplinary hospital with a liver transplantation program.Materials and methods: The authors examined 206 patients with liver cirrhosis from July 2019 to June 2021, with 20 of them undergoing TIPS. The mean age of the patients was 47.59 ± 9.55 years (35–65 years). Dynamic follow-up was performed at 3, 6, 9, 12, and 18 months. As a part of the dynamic follow-up, the patients underwent laboratory tests, abdomen ultrasound examination, and computed tomography imaging enhanced by the intravenous use of contrasting agent, endoscopy, esophagogastroduodenoscopy, and encephalopathy assessment.Results: No in-hospital TIPS-associated mortality has been reported. Two patients died in the hospital at the 19th and 26th day following the surgery because of the progression of liver failure, the 6-week mortality rate was 10%. In one patient (5%), an intraoperative complication was reported, i.e., intra-abdominal hemorrhage secondary to the migration of the stent under the liver capsule. The length of hospital stay after surgery was 7.34 ± 1.89 days (5–26 days). Long-term outcomes were available for 17 patients. The duration of the dynamic follow-up was 13.23 ± 2.47 months (3–24 months) and 2 (11,7%) deaths were reported. One patient (5.8%) was diagnosed with a shunt thrombosis at 12 months after the surgery. Three patients underwent liver transplantation after TIPS. The current one-year survival rate is 90%.Conclusion: TIPS is a safe and effective procedure decreasing mortality and improving quality of life of patients awaiting cadaveric liver transplantation. TIPS should be widely implemented in multidisciplinary hospitals having liver transplant program.