Transjugular intrahepatic portosystemic shunt in the treatment of portal vein thrombosis: a critical review of literature.
Transjugular intrahepatic portosystemic shunt in the treatment of portal vein thrombosis: a critical review of literature.
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经颈静脉肝内门体分流术治疗门静脉血栓：文献综述。
DOI：
10.1007/s12072-011-9324-5
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发表时间：
2012-06
影响因子：
6.6
通讯作者：
Han G
中科院分区：
文献类型：
--
作者：
Qi X;Han G
由于手术的技术难度和潜在的手术相关并发症，经颈静脉肝内门体分流术（TIPS）成功治疗门静脉血栓形成（PVT）患者的报告被认为是轶事。进行了文献综述，以确定TIPS治疗PVT的可行性和安全性。通过检索PUBMED和MEDLINE数据库，确定了所有在PVT患者中尝试TIPS的研究。54篇文章共报告了424例接受TIPS的PVT患者。在19个病例系列中，TIPS插入成功率为67-100%。此外，85例门静脉海绵状瘤患者成功接受了TIPS插入。TIPS置入的治疗策略有三种：（1）TIPS置入，然后通过分流术再通门静脉;（2）经皮途径再通门静脉，然后TIPS置入;（3）TIPS插入肝静脉和大侧支血管之间，但不再通门静脉。采用四种入路进入门静脉：经颈静脉、经鞘管、经脾和经肠系膜。腹腔内出血继发于肝包膜穿孔是致命的，只有三名患者。未报告肺栓塞事件。其他手术相关并发症是可逆的。分流功能障碍和肝性脑病的总发生率分别为8-33%和0- 50%。总之，回顾的研究一致支持TIPS治疗PVT的可行性和安全性，即使存在门静脉海绵状瘤。此外，还讨论了几个尚未解决的主要问题。
Reports of successful transjugular intrahepatic portosystemic shunt (TIPS) surgery in patients with portal vein thrombosis (PVT) are considered anecdotal owing to the technical difficulty of the procedure and potential procedure-related complications. A literature review was undertaken to determine the feasibility and safety of TIPS in the treatment of PVT. All studies in which TIPS was attempted in patients with PVT were identified by searching through the PUBMED and MEDLINE databases. A total of 424 PVT patients undergoing TIPS were reported in 54 articles. The success rate of TIPS insertion was 67–100% in 19 case series. Further, 85 patients with portal cavernoma underwent successful TIPS insertions. Three therapeutic strategies of TIPS placement were used: (1) TIPS placement followed by portal vein recanalization via the shunt, (2) portal vein recanalization via percutaneous approaches followed by TIPS placement, and (3) TIPS insertion between a hepatic vein and a large collateral vessel without portal vein recanalization. Four approaches were used to access the portal vein: transjugular, transhepatic, transsplenic, and transmesenteric. Intra-abdominal hemorrhage secondary to hepatic capsule perforation was lethal in only three patients. No episode of pulmonary embolism was reported. Other procedure-related complications were reversible. The overall incidence of shunt dysfunction and hepatic encephalopathy was 8–33% and 0–50%, respectively. In conclusion, the reviewed studies uniformly support the feasibility and safety of TIPS for PVT even in the presence of portal cavernoma. Further, several major issues that remain unresolved are discussed.
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影响因子：
4.3
作者：
Finkenstedt, Armin;Graziadei, Ivo W.;Vogel, Wolfgang
通讯作者：
Vogel, Wolfgang
影响因子：
4.6
作者：
Englesbe, Michael J.;Kubus, James;Pelletier, Shawn J.
通讯作者：
Pelletier, Shawn J.
影响因子：
13.5
作者：
Amitrano, L;Brancaccio, V;Balzano, A
通讯作者：
Balzano, A
影响因子：
158.5
作者：
Carlos Garcia-Pagan, Juan;Caca, Karel;Bosch, Jaime
通讯作者：
Bosch, Jaime
影响因子：
19.7
作者：
Adamus, Ralf;Pfister, Marcus;Loose, Reinhard W. R.
通讯作者：
Loose, Reinhard W. R.