Therapeutic effect and safety of transjugular intrahepatic portosystemic shunt in patients with primary biliary cirrhosis and portal hypertension

Objective To investigate the short- term effect and safety of transjugular intrahepatic portosystemic shunt( TIPS) in the treatment of decompensated primary biliary cirrhosis( PBC). Methods The clinical data of 26 patients with decompensated PBC who received TIPS in Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2009 to May 2015 were analyzed retrospectively.The indicators including portal venous pressure,liver function,and survival before and after TIPS during 1 year of follow up were compared.The Friedman test was applied as the rank sum test for multiple related samples,the Wilcoxon test was applied as the paired rank sum test,and the Kaplan- Meier curve was applied for survival analysis. Results All patients had significantly reduced mean portal pressure after TIPS( 1911( 16. 35- 22. 05) mm Hg vs 27. 93( 25. 26- 30. 87) mm Hg; Z =- 4. 199,P < 0. 001). Within 3 months after TIPS,the patients showed significant increases in total bilirubin,Model for End- Stage Liver Disease score,and bile acid( χ2= 26. 000,18. 429,and16. 353,all P < 0. 001). The most common postoperative complication was pyrexia,which had an incidence rate of 80. 77%( 21 /26),followed by hepatic encephalopathy,with an incidence rate of 19. 23%( 7 /26). The survival rates at 6 and 12 months after surgery were both92. 3%( 24 /26). Conclusions TIPS has good short- to medium- term effect and safety in the treatment of decompensated PBC,and its long- term effect still needs to be proved.