Outcomes of transjugular intrahepatic portosystemic shunt in treatment of hepatic sinusoidal obstruction syndrome due to gynura segetum

doi:10.3877/cma.j.issn.2095-5782.2023.01.005

Abstract

Abstract:

Objective

To investigate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of hepatic sinusoidal obstruction syndrome (HSOS) caused by gynura segetum.

Methods

From December 2016 to August 2020, the clinical data of 16 patients (10 males and 6 females) with HSOS caused by gynura segetum were retrospectively analyzed. All patients received TIPS treatment after poor response to conservative treatment. The technical success, clinical success of TIPS and procedure-related complications were evaluated.

Results

TIPS procedures were performed successfully in all patients. The portal pressure gradient (PPG) decreased from (36.2 ± 5.6) to (21.2 ± 5.0) mmHg(P < 0.05). Clinical success was achieved in thirteen patients (81.3%). And one month and three months after the procedures, the patients' concentrations of aspartate aminotransferse (AST), alanine aminotransferase (ALT), total bilirubin (TBIL) and model for end-stage liver disease (MELD) scores were all significantly lower than those before the TIPS. The severe short-term complication included septic shock (n = 1) and peritonitis (n = 1).

Conclusions

In the case of ineffective conservative treatment such as anticoagulation and liver protecting treatment, TIPS was safe and effective in the management of HSOS due to gynura segetum.

Key words: Sinusoidal obstruction syndrome, Portasystemic shunt, transjugular intrahepatic, Gynura segetum

Zhennan Dong, Junzheng Wu, Sheng Liu, Wei Yang, Haibin Shi, Weizhong Zhou. Outcomes of transjugular intrahepatic portosystemic shunt in treatment of hepatic sinusoidal obstruction syndrome due to gynura segetum[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2023, 11(01): 25-29.

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Figures/Tables 5

References 14

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变量	数值
性别（男/女）	10/6
年龄（岁）	58.1 ± 10.4
临床表现（%）
腹水	16（100）
腹胀	16（100）
肝肿大	12（68.8）
肝区痛	6（37.5）
黄疸	8（50）
体重增加	8（50）
MELD评分	15.3 ± 5.8
土三七来源（酒/茶/粉剂）	2/5/9
服用土三七时间（周）	3.4 ± 3.3

变量	数值
性别（男/女）	10/6
年龄（岁）	58.1 ± 10.4
临床表现（%）
腹水	16（100）
腹胀	16（100）
肝肿大	12（68.8）
肝区痛	6（37.5）
黄疸	8（50）
体重增加	8（50）
MELD评分	15.3 ± 5.8
土三七来源（酒/茶/粉剂）	2/5/9
服用土三七时间（周）	3.4 ± 3.3

变量	术前	术后1个月		术后3个月
变量	术前	数值	P值	数值	P值
AST^a	54.5（23.0~400.7）	31.5（18.7~193.8）	0.013	35.0（24.9~43.1）	0.001
ALT^a	38.2（10.6~349.0）	26.7（41.0~219.9）	0.019	22.2（10.3~35.7）	0.013
TBIL	74.8 ± 68.1	38.9 ± 19.9	0.093	34.9 ± 19.3	0.028
MELD评分	15.3 ± 5.8	11.0 ± 3.4	0.010	10.4 ± 2.4	0.003

变量	术前	术后1个月		术后3个月
变量	术前	数值	P值	数值	P值
AST^a	54.5（23.0~400.7）	31.5（18.7~193.8）	0.013	35.0（24.9~43.1）	0.001
ALT^a	38.2（10.6~349.0）	26.7（41.0~219.9）	0.019	22.2（10.3~35.7）	0.013
TBIL	74.8 ± 68.1	38.9 ± 19.9	0.093	34.9 ± 19.3	0.028
MELD评分	15.3 ± 5.8	11.0 ± 3.4	0.010	10.4 ± 2.4	0.003

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