title: Clinical effects and complications of TIPS for portal hypertension due to cirrhosis: a single center.
abstract: OBJECTIVE
  To determine the clinical effects and complications of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension due to cirrhosis.
  
  
  METHODS
  Two hundred and eighty patients with portal hypertension due to cirrhosis who underwent TIPS were retrospectively evaluated. Portal trunk pressure was measured before and after surgery. The changes in hemodynamics and the condition of the stent were assessed by ultrasound and the esophageal and fundic veins observed endoscopically.
  
  
  RESULTS
  The success rate of TIPS was 99.3%. The portal trunk pressure was 26.8 ± 3.6 cmH2O after surgery and 46.5 ± 3.4 cmH2O before surgery (P < 0.01). The velocity of blood flow in the portal vein increased. The internal diameters of the portal and splenic veins were reduced. The short-term hemostasis rate was 100%. Esophageal varices disappeared completely in 68% of patients and were obviously reduced in 32%. Varices of the stomach fundus disappeared completely in 80% and were obviously reduced in 20% of patients. Ascites disappeared in 62%, were markedly reduced in 24%, but were still apparent in 14% of patients. The total effective rate of ascites reduction was 86%. Hydrothorax completely disappeared in 100% of patients. The incidence of post-operative stent stenosis was 24% at 12 mo and 34% at 24 mo. The incidence of post-operative hepatic encephalopathy was 12% at 3 mo, 17% at 6 mo and 19% at 12 mo. The incidence of post-operative recurrent hemorrhage was 9% at 12 mo, 19% at 24 mo and 35% at 36 mo. The cumulative survival rate was 86% at 12 mo, 81% at 24 mo, 75% at 36 mo, 57% at 48 mo and 45% at 60 mo.
  
  
  CONCLUSIONS
  TIPS can effectively lower portal hypertension due to cirrhosis. It is significantly effective for hemorrhage of the digestive tract due to rupture of esophageal and fundic veins and for ascites and hydrothorax caused by portal hypertension.
authors.affiliation: Jian-Ping Qin, Ming-De Jiang, Wen Tang, Xiao-Ling Wu, Xin Yao, Wei-Zheng Zeng, Hui Xu, Department of Digestion, Chengdu Military General Hospital, Chengdu 610083, Sichuan Province, China.
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Qin
authors.forename: Ming-De
authors.initials: MD
authors.lastname: Jiang
authors.forename: Wen
authors.initials: W
authors.lastname: Tang
authors.forename: Xiao-Ling
authors.initials: XL
authors.lastname: Wu
authors.forename: Xin
authors.initials: X
authors.lastname: Yao
authors.forename: Wei-Zheng
authors.initials: WZ
authors.lastname: Zeng
authors.forename: Hui
authors.initials: H
authors.lastname: Xu
authors.forename: Qian-Wen
authors.initials: QW
authors.lastname: He
authors.forename: Ming
authors.initials: M
authors.lastname: Gu
mesh_terms: D000328:Adult; D001201:Ascites / Q000453:epidemiology / Q000601:surgery; D002681:China / Q000453:epidemiology; D004932:Esophageal and Gastric Varices / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000601:surgery; D006501:Hepatic Encephalopathy / Q000453:epidemiology; D006801:Humans; D006876:Hydrothorax / Q000453:epidemiology / Q000601:surgery; D006975:Hypertension, Portal / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D015994:Incidence; D008103:Liver Cirrhosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D017082:Portal Pressure; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects* / Q000295:instrumentation; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: Cirrhosis; Complication; Portal hypertension; Therapeutic effect; Transjugular intrahepatic portosystemic shunt