{"title":"经颈静脉肝内门静脉大循环短路术(TIPS)对50例难治性腹水的治疗成绩","authors":"秀典 金沢, 義之 楢原, 健二 福田, 千紗 近藤, 滉智 張本, 洋子 松下, 秀子 城所, 玲樹 片倉, 正則 厚川, 保彦 滝, 祐 木村, 祐二 長田, 雄久 中塚, 長逸 坂本","doi":"10.11405/NISSHOSHI.106.356","DOIUrl":null,"url":null,"abstract":": In this prospective cohort study, we evaluated the use of transjugular intrahepatic portosystemic shunt (TIPS) in 50 patients with refractory ascites and a Child-Pugh score of 9.8. The mean duration of follow-up was 592 days. Ascites improved in 96% at 1 year and in 93% at 2 years. The cumulative survival rate was 71%, 52% and 18% at 1, 2 and 5 years. The Child-Pugh score and the performance status score improved significantly after TIPS. Thirty six patients required shunt revision during follow-up, due to shunt stenosis. Hepatic encephalopathy which was able to be controlled medically occurred in 26 patients. Our results suggest that although shunt revision may be needed, TIPS can control refractory ascites in most survival cases and improve QOL. However, the 5-year survival rate is still low in our TIPS-treated patients with refractory ascites.","PeriodicalId":341053,"journal":{"name":"The Japanese journal of gastro-enterology","volume":"65 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2009-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"経頸静脈的肝内門脈大循環短絡術（TIPS）による難治性腹水50例の治療成績\",\"authors\":\"秀典 金沢, 義之 楢原, 健二 福田, 千紗 近藤, 滉智 張本, 洋子 松下, 秀子 城所, 玲樹 片倉, 正則 厚川, 保彦 滝, 祐 木村, 祐二 長田, 雄久 中塚, 長逸 坂本\",\"doi\":\"10.11405/NISSHOSHI.106.356\",\"DOIUrl\":null,\"url\":null,\"abstract\":\": In this prospective cohort study, we evaluated the use of transjugular intrahepatic portosystemic shunt (TIPS) in 50 patients with refractory ascites and a Child-Pugh score of 9.8. The mean duration of follow-up was 592 days. Ascites improved in 96% at 1 year and in 93% at 2 years. The cumulative survival rate was 71%, 52% and 18% at 1, 2 and 5 years. The Child-Pugh score and the performance status score improved significantly after TIPS. Thirty six patients required shunt revision during follow-up, due to shunt stenosis. Hepatic encephalopathy which was able to be controlled medically occurred in 26 patients. Our results suggest that although shunt revision may be needed, TIPS can control refractory ascites in most survival cases and improve QOL. However, the 5-year survival rate is still low in our TIPS-treated patients with refractory ascites.\",\"PeriodicalId\":341053,\"journal\":{\"name\":\"The Japanese journal of gastro-enterology\",\"volume\":\"65 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2009-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Japanese journal of gastro-enterology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.11405/NISSHOSHI.106.356\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Japanese journal of gastro-enterology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.11405/NISSHOSHI.106.356","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
: In this prospective cohort study, we evaluated the use of transjugular intrahepatic portosystemic shunt (TIPS) in 50 patients with refractory ascites and a Child-Pugh score of 9.8. The mean duration of follow-up was 592 days. Ascites improved in 96% at 1 year and in 93% at 2 years. The cumulative survival rate was 71%, 52% and 18% at 1, 2 and 5 years. The Child-Pugh score and the performance status score improved significantly after TIPS. Thirty six patients required shunt revision during follow-up, due to shunt stenosis. Hepatic encephalopathy which was able to be controlled medically occurred in 26 patients. Our results suggest that although shunt revision may be needed, TIPS can control refractory ascites in most survival cases and improve QOL. However, the 5-year survival rate is still low in our TIPS-treated patients with refractory ascites.
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