Managment and prognosis of portal vein cavernosis in 65 adults
Li Lin, Dang Xiaowei, Li Luhao, Li Suxin, Wang Peiju, Shen Dongqi, Liu Shengyan
Published 2022-06-25
Cite as Chin J Gen Surg, 2022, 37(6): 410-413. DOI: 10.3760/cma.j.cn113855-20220121-00045
Abstract
ObjectiveTo investigate the clinical treatment options for cavernous transformation of portal vein (CTPV).
MethodsData of 65 CTPV patients receiving invasive treatment and followed up at the First Affiliated Hospital of Zhengzhou University between Apr 2011 and Apr 2021 were collected. Patients were divided into four groups based on different treatment option, 24 patients were treated with transjugular intrahepatic portosystemic stent-shunt (TIPS) and 11 patients with splenopneumopexy, while 22 patients underwent splenectomy and devascularization , 8 were treated by endoscopic variceal ligation . The difference of postoperative upper gastrointestinal bleeding and hepatic encephalopathy between the four groups were analyzed,
ResultsThere were no difference between four groups in sex, age, preoperative serum aspartate aminotransferase, total bilirubin, albuminand Child-Turcotte-Pugh grade. The incidence of hepatic encephalopathy in the TIPS group was 33.3%±9.6%、46.5%±10.3% and 64.4%±13.1% in half year, 1 year, and 3 years , respectively. Postoperative hepatic encephalopathy rate was higher in TIPS group(χ2=31.191,P=0.000). Three patients in the TIPS group developed upper gastrointestinal hemorrhage within 6 months after the operation, and postoperative upper gastrointestinal bleeding rate was higher in splenopneumopexy group(χ2=7.542,P=0.006),
ConclusionThe clinical treatment options for CTPV patients are complicated ,we should make individual treatment options depend on the etiology, clinical symptoms and site of blood flow obstruction.
Key words:
Hypertension,portal; Portasystennic shunt,tanjugular intrahepatic; Splenectomy
Contributor Information
Li Lin
Department of Hepatopancreatobiliary Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052, China
Dang Xiaowei
Department of Hepatopancreatobiliary Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052, China
Li Luhao
Department of Hepatopancreatobiliary Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052, China
Li Suxin
Department of Hepatopancreatobiliary Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052, China
Wang Peiju
Department of Hepatopancreatobiliary Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052, China
Shen Dongqi
Department of Hepatopancreatobiliary Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052, China
Liu Shengyan
Department of Hepatopancreatobiliary Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052, China
