Original Article

Transjugular intrahepatic portosystemic shunt: Where are we?

Volume 25 · Issue 3 Publish Date: June 15, 2014
Reskan Altun Emre Yıldırım Serkan Öcal Enver Akbaş Ali Harman Murat Korkmaz Haldun Selçuk
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Published In

Turkish Journal of Gastroenterology

Volume 25 · Issue 3

Pages: 298-303

History

Published Online: June 15, 2014

Copyright © 2014 Reskan Altun, Emre Yıldırım, Serkan Öcal, Enver Akbaş, Ali Harman, Murat Korkmaz, Haldun Selçuk

Reskan Altun
Department of Gastroenterology, Medicana International Hospital, Ankara, Turkey
Emre Yıldırım
Department of Gastroenterology, Başkent University Faculty of Medicine, Ankara, Turkey
Serkan Öcal
Department of Gastroenterology, Başkent University School of Medicine, Ankara, Turkey
Enver Akbaş
Department of Gastroenterology, Başkent University Faculty of Medicine, Ankara, Turkey
Ali Harman
Department of Radiology, Başkent University Faculty of Medicine, Ankara, Turkey
Murat Korkmaz
Department of Gastroenterology, Başkent University Faculty of Medicine, Ankara, Turkey
Haldun Selçuk
Department of Gastroenterology, Başkent University School of Medicine, Ankara, Turkey
Altun, R., Yıldırım, E., Öcal, S., Akbaş, E., Harman, A., Korkmaz, M., & Selçuk, H. (2014). Transjugular intrahepatic portosystemic shunt: Where are we?. Turkish Journal of Gastroenterology, 25(3), 298–303. https://doi.org/10.5152/tjg.2014.5621
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Abstract

Abstract Background/Aims: The purpose of this study was to evaluate the technical/hemodynamic success, complications, and biochemical/ hematologic consequences of transjugular intrahepatic portosystemic shunt (TIPS) created with 10-mm bare stents in our patients. Materials and Methods: Data of 27 cirrhotic patients (18 men and 9 women; mean age, 39.7±18.7 years) with a median MELD score 14 (range 7-31) treated with TIPS between January 2000 and August 2010 were evaluated retrospectively. Results: The indications were refractory bleeding varices in 48.2%, refractory ascites in 22.2%, and Budd-Chiari syndrome in 29.6% of the patients. Technical and hemodynamic success rates were 96.3% and 92.3%, respectively. Mean portosystemic pressure gradient decreased from 21.5±5.3 mm Hg to 9±2.7 mm Hg (p<0.05). The rate of primary stent patency was 76.9% 1 year after the procedure. No statistically significant difference in shunt dysfunction was found between the groups of patients treated for Budd-Chiari syndrome and other indications (p>0.05). One patient (3.7%) had shunt dysfunction due to thrombosis within 24 hours. New and/or worsening hepatic encephalopathy occurred in 34.6% of patients. Increased age (≥40 years) was significantly related to hepatic encephalopathy in both univariate and multivariate analyses (p<0.05). Thirty-day mortality rate and 1-year transplant-free survival rate were 0% and 80.7%, respectively. Conclusion: Transjugular intrahepatic portosystemic shunt procedure is a safe treatment for many patients with cirrhosis, but post-procedure hepatic encephalopathy and shunt dysfunction are still problems. Especially, patient age should be taken into consideration in predicting hepatic encephalopathy risk.

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Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 25 · Issue 3
Pages 298-303
DOI 10.5152/tjg.2014.5621
History
Published Online June 15, 2014
Copyright
Copyright (c) 2014 Reskan Altun, Emre Yıldırım, Serkan Öcal, Enver Akbaş, Ali Harman, Murat Korkmaz, Haldun Selçuk
Affiliations
Reskan Altun
Department of Gastroenterology, Medicana International Hospital, Ankara, Turkey
Emre Yıldırım
Department of Gastroenterology, Başkent University Faculty of Medicine, Ankara, Turkey
Serkan Öcal
Department of Gastroenterology, Başkent University School of Medicine, Ankara, Turkey
Enver Akbaş
Department of Gastroenterology, Başkent University Faculty of Medicine, Ankara, Turkey
Ali Harman
Department of Radiology, Başkent University Faculty of Medicine, Ankara, Turkey
Murat Korkmaz
Department of Gastroenterology, Başkent University Faculty of Medicine, Ankara, Turkey
Haldun Selçuk
Department of Gastroenterology, Başkent University School of Medicine, Ankara, Turkey
Cite this Article
Altun, R., Yıldırım, E., Öcal, S., Akbaş, E., Harman, A., Korkmaz, M., & Selçuk, H. (2014). Transjugular intrahepatic portosystemic shunt: Where are we?. Turkish Journal of Gastroenterology, 25(3), 298–303. https://doi.org/10.5152/tjg.2014.5621
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