Early results of transjugular intrahepatic portosystemic shunting in patients with complications of portal hypertension
AbstractObjective. This study aimed to analyze and evaluate early postoperative outcomes obtained within 3 months after transjugular intrahepatic portosystemic shunting (TIPS) in patients with acute bleeding from gastroesophageal varices and portal hypertension on the background of hepatocirrhosis.
Patients and methods. From 2019 to 2023 inclusively, TIPS procedures were performed in sixty 33-to78-year-old patients (32 men and 28 women) with cirrhosis of the liver and acute bleeding from varicose veins of the esophagus and stomach.
The grades of cirrhosis severity in our patients according to the Child-Pugh classification were as follows: Child–Pugh A – 11 (18.3%), Child–Pugh B – 26 (43.3%), Child–Pugh C – 23 (38.4%). All endovascular surgical interventions were performed using Artiz Zeego and Philips Azurion 7 angiographs at the City Clinical Hospital № 15 named after O.M. Filatov. Statistical data processing was carried out using Microsoft Excel.
Results. The sixty patients underwent a total of 62 TIPS procedures. During the observation period of 3 months, the following changes were noted: two (3.3%) patients were found to have shunt thrombosis and one (1.7%) patient developed stenosis of the ostium of the right hepatic vein. These complications led to a relapse of portal hypertension. The overwhelming majority of the patients did not experience recurrent bleeding after the procedure. There were no cases of stent dislocation or signs of vessel perforation. Survival after surgery was 86.7% (52 patients), with mortality amounting to 13.3% (8 patients).
Conclusion. The creation of a transjugular intrahepatic portosystemic shunt is a minimally invasive, high-tech and reliable preventive operation in patients with esophageal variceal bleeding and portal hypertension on the background of liver cirrhosis.
Funding. The study had no financial support.
Conflict of interest. The authors declare no conflicts of interest.
Authors’ contribution. Study conception and design – Dzhurakulov Sh.R., Vechorko V.I., Severtsev A.N., Fakhriev J.A.; data collection and handling – Dzhurakulov Sh.R., Vechorko V.I., Fakhriev J.A..; statistical processing – Dzhurakulov Sh.R., Ibragimov S.A., Fakhriev J.A.; draft manuscript preparation – Dzhurakulov Sh.R., Ibragimov S.A., Fakhriev J.A.; manuscript revision – Dzhurakulov Sh.R., Severtsev A.N., Fakhriev J.A.
For citation: Dzhurakulov Sh.R., Vechorko V.I., Severtsev A.N., Anosov V.D., Ibragimov S.A., Fakhriev J.A. Early results of transjugular intrahepatic portosystemic shunting in patients with complications of portal hypertension. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2024; 30 (1): 80–7. DOI: https://doi.org/10.33029/1027-6661-2024-30-1-80-87
Keywords: liver cirrhosis; portal hypertension; transjugular intrahepatic portosystemic shunt; esophageal varices; acute variceal bleeding
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