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Observational Study
. 2023 Apr 14;69(4):e20220944.
doi: 10.1590/1806-9282.20220944. eCollection 2023.

Transjugular intrahepatic portosystemic shunt in decompensated cirrhotic patients in a tertiary hospital in southern Brazil

Carolina Moro Titton  1 , Marcio Torikachvili  1 , Heloísa M C Rêgo  1 , Eduardo F Medronha  1 , Enio Ziemiecki Junior  1 , Carolina Ribas  1 , Carlos Germano Ceratti  1 , Angelo Alves de Mattos  1 , Cristiane Valle Tovo  1
Affiliations
Observational Study

Transjugular intrahepatic portosystemic shunt in decompensated cirrhotic patients in a tertiary hospital in southern Brazil

Carolina Moro Titton et al. Rev Assoc Med Bras (1992). .

Abstract

Objective: The aim of the present study was to evaluate the outcomes of cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt.

Methods: A retrospective longitudinal observational study was carried out evaluating 38 cirrhotic patients undergoing transjugular intrahepatic portosystemic shunt. The outcomes were evaluated in an outpatient follow-up period of 3 months. The assumed significance level was 5%.

Results: The indications for transjugular intrahepatic portosystemic shunt were refractory ascites in 21 (55.3%), variceal hemorrhage in 13 (34.2%), and hydrothorax in 4 (10.5%) patients. There was development of hepatic encephalopathy in 10 (35.7%) patients after transjugular intrahepatic portosystemic shunt. From the 21 patients with refractory ascites, resolution was observed in 1 (3.1%) patient, and in 16 (50.0%) patients, there was ascites control. Regarding transjugular intrahepatic portosystemic shunt after variceal bleeding, 10 (76.9%) patients remained without new bleeding or hospitalizations in the follow-up period. The global survival in the follow-up period in patients with and without hepatic encephalopathy was 60 vs. 82%, respectively (p=0.032).

Conclusion: Transjugular intrahepatic portosystemic shunt can be considered in decompensated cirrhotic patients; however, the development of hepatic encephalopathy which can shorten survival should be focused.

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Conflict of interest statement

Conflicts of interest: the authors declare there is no conflicts of interest.

Figures

Figure 1
Figure 1. Overall survival at 3 months post-transjugular intrahepatic portosystemic shunt according to the presence or absence of hepatic encephalopathy. Kaplan-Meyer curve: p=0.032; hazard ratio=3.04 (95% confidence interval: 1.02–9.08).
Figure 2
Figure 2. Kaplan-Meyer curve to assess the survival of patients with ascites at 3 months post-transjugular intrahepatic portosystemic shunt.
See this image and copyright information in PMC

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