Clinical efficacy of transjugular intrahepatic portosystemic shunt in treating esophageal variceal bleeding in patients with liver cirrhosis.

OBJECTIVE

To explore the clinical efficacy of transjugular intrahepatic portal vein shunt (TIPS) in treating esophageal variceal bleeding (EVB) of liver cirrhosis patients.

METHODS

Clinical data of 60 patients with liver cirrhosis and EVB, admitted to The Second Affiliated Hospital of Bengbu Medical College between from November 2017 to April 2024, were retrospectively analyzed. Of them, 31 received TIPS treatment (TIPS group), and 29 received treatment with somatostatin (SST group). Blood transfusion volume, hemostasis time, and the length of hospital stay were compared between the two groups. Hemodynamic status, gastric motility indicators, vascular endothelial function indicators, levels of total bilirubin (TBIL), albumin (ALB), and international normalized ratio (INR) of both groups were compared before and after the treatment. The rebleeding and prognosis of patients were assessed after 6 months of follow-up.

RESULTS

The blood transfusion volume, hemostasis time, and length of hospital stay were significantly lower in the TIPS group than in the SST group (P<0.05). After the treatment, the hemodynamic status, gastric motility indicators, and vascular endothelial function indicators, in both groups significantly improved compared to those before treatment and were considerably better in patients treated by TIPS group compared to the SST group (P<0.05). There were no significant changes in the pretreatment and post-treatment levels of TBIL, ALB, and INR between the two groups (P>0.05). After six months of follow-up, the TIPS group showed significantly lower re-bleeding and mortality rates than the SST group (P<0.05).

CONCLUSIONS

Compared with conventional drug therapy, TIPS treatment can more effectively regulate hemodynamic status, improve gastric motility and vascular endothelial function, and reduce re-bleeding and mortality of patients with liver cirrhosis complicated by EVB.