Transjugular intrahepatic portosystemic shunt for chronic portal vein thrombosis and incidence of hepatic eeplopathy
نویسندگان
چکیده
Objective: This study investigated the relationship between the incidence of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) for chronic portal vein thrombosis (PVT) and the surgical procedures based on the anatomical classification of thrombosis. Methods: In the present retrospective study, 73 consecutive patients were diagnosed with chronic PVT and treated with TIPS with covered stent. Patients were enrolled between January 2012 and June 2015. The development of HE was assessed in the 1st, 3rd, and 12th months of their follow-up. A paired t-test was used to compare preand post-TIPS portal vein pressure. Results: Statistical differences were found between preand post-TIPS portal vein pressure intype I, II, III and IV patients (P<0.01). Minimal HE was mostly seen in type IV, IIa, and IIIa, respectively, at 1, 3, and 12 months, postoperatively. By contrast, the incidence of grade I HE was the highest in type IIa, IIIa, and IIb, respectively. Additionally, grade II HE occurred mostly in types IIb, IIa, and IIIb, respectively. Further, patients with type IIb and IIIb showed longer HE duration with a follow-up of 12 months. Conclusions: An appropriate anatomical classification of chronic PVT is essential for the application of TIPS clinically. The incidence of postoperative HE is higher in patients with simple thrombosis associated with the main portal veinor superior mesenteric vein.
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