The risk factors of hepatic failure after transjugular intrahepatic portosystemic stent shunt forprimary hepatocellular carcinoma with portal hypertension
ZHAO Meng-fei, LIU Fu-quan, YUE Zhen-dong, ZHAO Hong-wei, WANG Lei, YAO Jian-nan, ZUO Li, FAN Zhen-hua
Beijing Shijitan Hospital of Capital Medical University, Beijing 100038, China
Abstract：Objective: To analyze the risk factors which lead primary hepatocellular carcinoma with portal hypertension to hepatic failure after transjugular intrahepatic portosystemic stent shunt(TIPSS). Materials and Methods: From January 2007 to December 2010, a cohort of 69 hospitalized patients diagnosed as primary hepatocellular carcinoma with portal hypertension(refractory variceal hemorrhage and/or refractory ascites) treated with TIPSS were retrospectively studied, and data were abstracted including baseline characteristics of patients and the incidence of hepatic failure. We analyzed the risk factors which lead to hepatic failure by statistical methods. Results: Technical success rate was 100%. 26 cases got hepatic failure in 0.5~47 months after operation, of whom 11 cases got remission after aggressive medical therapy, 15 cases died. After retrospective analysis, we found Child-Turcotte-Pugh(CTP) grading, tumor diameter, the diameter of stent, whether combined with portal vein thrombosis, the time of transarterial chemoembolization(TACE)/hepatic artery embolization(TAE), either a history of surgical excision before TIPSS, or a history of recurrent bleeding and hepatic encephalopathy after TIPSS, were all risk factors. Conclusions: TIPSS can effectively relieve the symptoms of portal hypertension, but it has a risk of hepatic failure. Realized the factors that lead primary hepatocellular carcinoma with portal hypertension to hepatic failure after TIPSS, we can screen patients suitable for TIPSS to get better results.
2013, Vol. 24 
