Transjugular intrahepatic portosystemic shunt creation for portal hypertension in patients with hepatocellular carcinoma: A systematic review

Gastrointestinal Intervention Pub Date : 2018-10-31 DOI:10.18528/GII180026

He Zhao, J. Tsauo, Xiaowu Zhang, T. Gong, Jinggui Li, Xiao Li

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引用次数: 6

Abstract

Background: To evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) creation for the management of portal hy- pertension in patients with hepatocellular carcinoma (HCC). Methods: A literature search of the MEDLINE/PubMed and Embase databases was conducted. All articles reporting the outcomes of TIPS creation for variceal bleeding and refractory ascites and hepatic hydrothorax in patients with HCC were included. Exclusion criteria were non-English language, sample size < 5, data not extractable, and data reported in another article. Results: A total of 280 patients (mean age, 48 – 58; male gender, 66%) from five articles were included. TIPS creation was performed for variceal bleeding in 79% and refractory ascites and/or hepatic hydrothorax in 26% of patients. Technical and clinical success was achieved in 99% and 64% of patients, respectively. Clinical failure occurred in 36% of patients due to rebleeding or recurrent bleeding (n = 77) or no resolution or improvement of refractory ascites and hepatic hydrothorax (n = 24). One percent of patient had major complications, including accelerated liver failure (n = 1) and multi-organ failure resulting from hemorrhagic shock (n = 1), all of which resulted in early (i.e., within 30 days) death. Hepatic encephalopathy occurred in 40% of patients after TIPS creation. Lung metastasis was found 1% of patient 5 months (n = 1) and 72 months (n = 1) after TIPS creation. Conclusion: TIPS creation seems to be safe and effective for the management of portal hypertension in patients with HCC.

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经颈静脉肝内门体分流术治疗肝细胞癌患者门静脉高压的系统评价

背景:评价经颈静脉肝内门静脉系统分流术(TIPS)治疗肝细胞癌(HCC)患者门静脉高压的安全性和有效性。方法:检索MEDLINE/PubMed和Embase数据库的文献。所有报道TIPS治疗HCC患者静脉曲张出血、难治性腹水和肝性胸水的结果的文章均被纳入。排除标准是非英语语言，样本量< 5，数据不可提取，数据在另一篇文章中报告。结果:共280例患者，平均年龄48 ~ 58岁;男性(66%)，来自5篇文章。79%的患者静脉曲张出血，26%的患者难治性腹水和/或肝性胸水。技术和临床成功率分别为99%和64%。36%的患者因再出血或复发性出血(n = 77)或难治性腹水和肝性胸水未得到缓解或改善(n = 24)而出现临床失败。1%的患者出现严重并发症，包括加速肝功能衰竭(n = 1)和由失血性休克引起的多器官衰竭(n = 1)，所有这些都导致早期(即30天内)死亡。肝性脑病发生在TIPS创建后的40%的患者。在TIPS创建后5个月(n = 1)和72个月(n = 1)，有1%的患者发现肺转移。结论:TIPS治疗肝细胞癌门静脉高压症安全有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gastrointestinal Intervention

自引率

0.00%

发文量

审稿时长

24 weeks

期刊介绍： IJGII (pISSN 2636-0004, eISSN 2636-0012) was published four times a year on the last day of January, April, July, and October, which has effected from January 1 in 2019. This Journal was first published biannually on June and December, beginning in December 2012 under the title ‘Gastrointestinal Intervention’ (former pISSN 2213-1795, eISSN 2213-1809) and was changed to be published three times a year from 2016. Commencing with the January 2019 issue, the Journal was renamed ‘International Journal of Gastrointestinal Intervention’. As the official journal of the Society of Gastrointestinal Intervention (SGI), International Journal of Gastrointestinal Intervention (IJGII) delivers original, peer-reviewed articles for gastroenterologists, interventional radiologists, surgeons, gastrointestinal oncologists, nurses and technicians who need current and reliable information on the interventional treatment of gastrointestinal and hepatopancreaticobiliary diseases. Regular features also include ‘state-of-the-art’ review articles by leading authorities throughout the world. IJGII will become an international forum for the description and discussion of the various aspects of interventional radiology, endoscopy and minimally invasive surgery.