Abstract Objective: To investigate the safety and efficacy of emergency transjugular intrahepatic portosystemic shunt(TIPS) in the treatment of esophageal and gastric variceal bleeding(EGVB) in liver cirrhosis and portal hypertension. Methods: The clinical data of 14 EVGB patients with liver cirrhosis and portal hypertension who undergoing emergency TIPS were retrospectively analyzed. The haemostasis, hepatic vein pressure gradient(HVPG), liver function, complications, rebleeding and in-stent occlusion were observed. The paired-samples t-test was performed for measurement data. Results: All emergency TIPS of the 14 patients were successful. There was no perioprative serious complication. The HVPG dropped from (38.9±9.0) cm H2O to (19.1±7.0) cm H2O(P<0.001). There was no significant difference in liver function between before and after operation. The bleeding stopped in 72 hours after operation in all patients． There was no rebleeding occurred during 3~12 months followed-up, one patient died of perforation of stomach, one patient underwent liver transplantation, and 2 patients had mild hepatic encephalopathy. There was none in-stent occlusion assessed by ultrasound and computed tomography during follwed-up. Conclusion: The emergency TIPS is safe and effective in the treatment of acute EGVB in cirrhotic patients with portal hypertension．
MA Yu-jia,GONG Zheng,CHI Yuan, et al. Evaluation of emergency transjugular intrahepatic portosystemic shunt in the treatment of variceal bleeding in liver cirrhosis[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(12): 888-892.
[1]中华医学会消化病学分会，中华医学会肝病学分会，中华医学会内镜学分会，等. 肝硬化门静脉高压食管胃静脉曲张出血的防治共识（2008，杭州）[J]. 中华消化杂志，2008，28（8）：551-558.
[2]中华医学会消化病学分会消化介入学组. 经颈静脉肝内门体静脉分流术治疗肝硬化门静脉高压共识意见[J]. 中华消化杂志，2014，34（1）：3-6.
[3]García-Pagán JC, Caca K, Bureau C, et al. Early use of TIPS in patients with cirrhosis and variceal bleeding[J]. N Engl J Med, 2010, 362(25): 2370-2379.
[4]徐克，韩国宏. 正确认识经颈静脉肝内门体分流术治疗肝硬化门静脉高压并发症的地位[J]. 中华肝脏病杂志，2011，19（7）：481-482.
[5]Garcia-Pagán JC, Di Pascoli M, Caca K, et al． Use of early-TIPS for high-risk variceal bleeding: results of a post-RCT surveillance study[J]. J Hepatol, 2013, 58(1): 45-50.
[6]Alam S, Britton E, Shaikh U, et al. Early Tips(transjugular intrahepatic portosystemic shunt) For Acute Variceal Bleeding Complicating Alcoholic Hepatitis(ah)[J]. Gut, 2014, 63(Suppl 1): A193.
[7]de Franchis R, Baveno Ⅵ Faculty. Expanding consensus in portal hypertension: Report of the Baveno Ⅵ Consensus Workshop: Stratifying risk and individualizing care for portal hypertension[J]. J Hepatol, 2015, 63(3): 743-752.
[8]尤丽英，李迎春，闫东，等. 经颈静脉肝内门体分流术治疗肝硬化合并食管胃底静脉曲张破裂出血的研究[J]. 中华肝脏病杂志，2011，19（7）：490-493.
[9]Chen Y, Ye P, Li Y, et al. Percutaneous transhepatic balloon-assisted transjugular intrahepatic portosystemic shunt for chronic, totally occluded, portal vein thrombosis with symptomatic portal hypertension: procedure technique, safety, and clinical applications[J]. Eur Radiol, 2015, 25(12): 3431-3437.
[10]李鑫，王黎洲，蒋天鹏，等. 使用覆膜支架行TIPS治疗原发性肝癌并门静脉高压的疗效分析[J]. 中华肝脏病杂志，2016，24（5）：387-388.
[11]褚建国，孙晓丽，朴龙松，等. 门静脉左支分流降低术后肝性脑病的临床研究[J]. 中华肝脏病杂志，2002，10（6）：437-440.
[12]Yang Z, Han G, Wu Q, et al. Patency and clinical outcomes of transjugular intrahepatic portosystemic shunt with polytetrafluoroethylene-covered stents versus bare stents: a meta-analysis[J]. J Gastroenterol Hepatol, 2010, 25(11): 1718-1725.
[13]Wang L, Xiao Z, Yue Z, et al. Efficacy of covered and bare stent in TIPS for cirrhotic portal hypertension: A single-center randomized trial[J]. Sci Rep, 2016, 6: 210-211.
[14]La Mura V, Abraldes JG, Berzigotti A, et al. Right atrial pressure is not adequate to calculate portal pressure gradient in cirrhosis: a clinical-hemodynamic correlation study[J]. Hepatology, 2010, 51(6): 2108-2116.
