Clinical outcomes of transjugular intrahepatic portosystemic shunt for portal hypertension: Korean multicenter real-practice data
Korean Journal of Hepatology 2014³â 20±Ç 1È£ p.18 ~ p.27
±èÇü±â(Kim Hyung-Ki) - Soonchunhyang University College of Medicine Department of Internal Medicine
±èÀ±ÁØ(Kim Yoon-Jun) - Seoul National University College of Medicine Department of Internal Medicine
Á¤¿ìÁø(Chung Woo-Jin) - Keimyung University School of Medicine Department of Internal Medicine
±è¼ø¼±(Kim Soon-Sun) - Ajou University College of Medicine Department of Internal Medicine
½ÉÀçÁØ(Shim Jae-Jun) - Kyung Hee University School of Medicine Department of Internal Medicine
ÃÖ¹®¼®(Choi Moon-Seok) - Sungkyunkwan University School of Medicine Department of Internal Medicine
±èµµ¿µ(Kim Do-Young) - Yonsei University College of Medicine Department of Internal Medicine
Àü´ë¿ø(Jun Dae-Won) - Hanyang University College of Medicine Department of Internal Medicine
¾ö¼øÈ£(Um Soon-Ho) - Korea University College of Medicine Department of Internal Medicine
¹Ú¼ºÀç(Park Sung-Jae) - Inje University College of Medicine Department of Internal Medicine
¿ìÇö¿µ(Woo Hyun-Young) - Pusan National University College of Medicine Department of Internal Medicine
Á¤¿µ°É(Jung Young-Kul) - Gachon University of Medicine and Science Department of Internal Medicine
¹é¼ø±¸(Baik Soon-Koo) - Yonsei University Wonju College of Medicine Department of Internal Medicine
±è¹®¿µ(Kim Moon-Young) - Yonsei University Wonju College of Medicine Department of Internal Medicine
¹Ú¼ö¿µ(Park Soo-Young) - Kyungpook National University School of Medicine Department of Internal Medicine
ÀÌÀç¸í(Lee Jae-Myeong) - Soonchunhyang University College of Medicine Department of Internal Medicine
±è¿µ¼®(Kim Young-Seok) - Soonchunhyang University College of Medicine Department of Internal Medicine
Abstract
Background/Aims: This retrospective study assessed the clinical outcome of a transjugular intrahepatic portosystemic shunt (TIPS) procedure for managing portal hypertension in Koreans with liver cirrhosis.
Methods: Between January 2003 and July 2013, 230 patients received a TIPS in 13 university-based hospitals.
Results: Of the 229 (99.6%) patients who successfully underwent TIPS placement, 142 received a TIPS for variceal bleeding, 84 for refractory ascites, and 3 for other indications. The follow-up period was 24.9¡¾30.2 months (mean¡¾SD), 74.7% of the stents were covered, and the primary patency rate at the 1-year follow-up was 78.7%. Hemorrhage occurred in 30 (21.1%) patients during follow-up; of these, 28 (93.3%) cases of rebleeding were associated with stent dysfunction. Fifty-four (23.6%) patients developed new hepatic encephalopathy, and most of these patients were successfully managed conservatively. The cumulative survival rates at 1, 6, 12, and 24 months were 87.5%, 75.0%, 66.8%, and 57.5%, respectively. A high Model for End-Stage Liver Disease (MELD) score was significantly associated with the risk of death within the first month after receiving a TIPS (P=0.018). Old age (P<0.001), indication for a TIPS (ascites vs. bleeding, P=0.005), low serum albumin (P<0.001), and high MELD score (P=0.006) were associated with overall mortality.
Conclusions: A high MELD score was found to be significantly associated with early and overall mortality rate in TIPS patients. Determining the appropriate indication is warranted to improve survival in these patients.
Å°¿öµå
Liver cirrhosis, Transjugular intrahepatic portosystemic shunt, Portal hypertension
KMID :
1103920140200010018
¿ø¹® ¹× ¸µÅ©¾Æ¿ô Á¤º¸
µîÀçÀú³Î Á¤º¸
À¯È¿¼º°á°ú(Recomendation)