[An experience of transjugular intrahepatic portosystemic shunt in the treatment of gastroesophageal varices].

ABSTRACT

Transjugular intrahepatic portosystemic shunt (TIPS) using an 8-mm Gianturco-Rösch Z stent was performed in 10 patients with liver cirrhosis admitted due to ruptured gastroesophageal varices. The treatment was successful in 9 patients, and the portal pressure decreased form 25 mmHg to 17 mmHg immediately after TIPS and to 15 mmHg 2 weeks after TIPS. The patency of the shunt was maintained adequately in the patients examined 3 months after TIPS. Endoscopy 1 month after TIPS showed improvements in the gastroesophageal varices in all patients. Hemobilia and intraperitoneal bleeding were observed in 1 patient each during procedure. Transient jaundice was observed in 2 and increase in the blood ammonia level were noted in 3 (one of whom had hepatic encephalopathy) postoperatively. All these complications could be treated easily. TIPS which brings about an immediate marked reduction in the portal pressure appears to be promising as a new treatment for portal hypertension.