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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.
Liver Int. 2009 Aug; 29(7):1101-9.LI

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.

Authors+Show Affiliations

Department of Gastroenterology, Southwest Hospital, Third Military Medical University, Chongqing, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19386025

Citation

Chen, Lei, et al. "Outcomes of Transjugular Intrahepatic Portosystemic Shunt Through the Left Branch Vs. the Right Branch of the Portal Vein in Advanced Cirrhosis: a Randomized Trial." Liver International : Official Journal of the International Association for the Study of the Liver, vol. 29, no. 7, 2009, pp. 1101-9.
Chen L, Xiao T, Chen W, et al. Outcomes of transjugular intrahepatic portosystemic shunt through the left branch vs. the right branch of the portal vein in advanced cirrhosis: a randomized trial. Liver Int. 2009;29(7):1101-9.
Chen, L., Xiao, T., Chen, W., Long, Q., Li, R., Fang, D., & Wang, R. (2009). Outcomes of transjugular intrahepatic portosystemic shunt through the left branch vs. the right branch of the portal vein in advanced cirrhosis: a randomized trial. Liver International : Official Journal of the International Association for the Study of the Liver, 29(7), 1101-9. https://doi.org/10.1111/j.1478-3231.2009.02016.x
Chen L, et al. Outcomes of Transjugular Intrahepatic Portosystemic Shunt Through the Left Branch Vs. the Right Branch of the Portal Vein in Advanced Cirrhosis: a Randomized Trial. Liver Int. 2009;29(7):1101-9. PubMed PMID: 19386025.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes of transjugular intrahepatic portosystemic shunt through the left branch vs. the right branch of the portal vein in advanced cirrhosis: a randomized trial. AU - Chen,Lei, AU - Xiao,Tianli, AU - Chen,Wensheng, AU - Long,Qingling, AU - Li,Rongjun, AU - Fang,Dianchun, AU - Wang,Rongquan, Y1 - 2009/04/06/ PY - 2009/4/24/entrez PY - 2009/4/24/pubmed PY - 2009/9/11/medline SP - 1101 EP - 9 JF - Liver international : official journal of the International Association for the Study of the Liver JO - Liver Int VL - 29 IS - 7 N2 - 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. SN - 1478-3231 UR - https://www.unboundmedicine.com/medline/citation/19386025/Outcomes_of_transjugular_intrahepatic_portosystemic_shunt_through_the_left_branch_vs__the_right_branch_of_the_portal_vein_in_advanced_cirrhosis:_a_randomized_trial_ L2 - https://doi.org/10.1111/j.1478-3231.2009.02016.x DB - PRIME DP - Unbound Medicine ER -