Volume 29, Issue 7 pp. 1101-1109

Outcomes of transjugular intrahepatic portosystemic shunt through the left branch vs. the right branch of the portal vein in advanced cirrhosis: a randomized trial

Lei Chen,

Lei Chen

Department of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing, China

^*These authors contributed equally.

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Tianli Xiao,

Tianli Xiao

Department of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing, China

^*These authors contributed equally.

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Wensheng Chen,

Wensheng Chen

Department of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing, China

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Qingling Long,

Qingling Long

Department of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing, China

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Rongjun Li,

Rongjun Li

Department of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing, China

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Dianchun Fang,

Dianchun Fang

Department of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing, China

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Rongquan Wang,

Rongquan Wang

Department of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing, China

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Lei Chen,

Lei Chen

Department of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing, China

^*These authors contributed equally.

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Tianli Xiao,

Tianli Xiao

Department of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing, China

^*These authors contributed equally.

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Wensheng Chen,

Wensheng Chen

Department of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing, China

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Qingling Long,

Qingling Long

Department of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing, China

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Rongjun Li,

Rongjun Li

Department of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing, China

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Dianchun Fang,

Dianchun Fang

Department of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing, China

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Rongquan Wang,

Rongquan Wang

Department of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing, China

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First published: 02 July 2009

https://doi.org/10.1111/j.1478-3231.2009.02016.x

Citations: 47

Correspondence
Prof. Rongquan Wang, MD, PhD, Department of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
Tel: +023 65478216 (H), +023 68754124
Fax: +023 65410853
e-mail: [email protected]

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Abstract

Background/Aims: The transjugular intrahepatic portosystemic shunt (TIPS) is technically divided into TIPS through the left branch of the portal vein (TIPS-LBPV) and TIPS through the right branch of the portal vein (TIPS-RBPV). In order to compare their advantages and disadvantages, this randomized, controlled trial was designed to investigate their outcomes in advanced cirrhotic patients.

Methods: Seventy-two patients were randomly placed into TIPS-LBPV (36 patients) and TIPS-RBPV (36 patients, with four failures) groups, and they were prospectively followed for 2 years after TIPS implantation.

Results: Patients who underwent the two different kinds of TIPS were balanced during recruitment for this study. The incidences of overall encephalopathy and de novo encephalopathy in the TIPS-LBPV group were significantly lower than that of the TIPS-RBPV group during follow-up (P=0.036 and 0.012 respectively). The incidences of rebleeding or re-intervention and improvement of ascites were similar between groups (P>0.05). Patients undergoing TIPS-RBPV required more rehospitalization and incurred more costs than those who underwent TIPS-LBPV (P=0.030 and 0.039 respectively). There was no significant difference between the two groups in survival based on a survival curve constructed according to the Kaplan–Meier method (P>0.05).

Conclusion: Patients undergoing TIPS-LBPV had a lower incidence of encephalopathy, less rehospitalization and lower costs after TIPS implantation compared with patients undergoing TIPS-RBPV.

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Volume29, Issue7

August 2009

Pages 1101-1109

Outcomes of transjugular intrahepatic portosystemic shunt through the left branch vs. the right branch of the portal vein in advanced cirrhosis: a randomized trial

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Outcomes of transjugular intrahepatic portosystemic shunt through the left branch vs. the right branch of the portal vein in advanced cirrhosis: a randomized trial

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