Direct Intrahepatic Portocaval Shunt for Sinusoidal Obstruction Syndrome Associated with Hepatotoxicity of Pyrrolizidine Alkaloids

作者：Luo, Shihua; Chu, Jianguo^*; Huang, He; Yao, Kechun

来源：Biomed Research International, 2018, 2018: 9804582.

DOI：10.1155/2018/9804582

• HEPATIC VENOOCCLUSIVE DISEASE
• STEM-CELL TRANSPLANTATION
• BONE-MARROW-TRANSPLANTATION
• VENOUS OUTFLOW OBSTRUCTION
• BUDD-CHIARI-SYNDROME
• PORTOSYSTEMIC SHUNT
• PORTAL-HYPERTENSION
• OCCLUSIVE DISEASE
• GYNURA-SEGETUM
• TIPS

We retrospectively identified 89 consecutive patients fromJanuary 2004 to January 2012 to investigate efficacy of direct intrahepatic portocaval shunt (DIPS) combined with inferior vena cava (IVC) stenting for sinusoidal obstruction syndrome (SOS) associated with hepatotoxicity of pyrrolizidine alkaloids. Indications for treatment were variceal hemorrhage and/or refractory ascites. Patients were treated with DIPS plus IVC stenting (group A, n=68) or DIPS alone (group B, n=21). A technical success rate of 100% was obtained in all 89 patients, and there were no early procedure-related adverse events or 30-day mortality. Mean portosystemic gradient decreased in both groups. Changes in aspartate and alanine aminotransferases and total bilirubin did not differ between the groups. Ascites disappeared in group A but was not obvious in group B until IVC stenting. During follow-up, recurrent bleeding and ascites and incidence of hepatic encephalopathy did not differ between the groups. The 1-, 3-, and 5-year survival rate was 98, 89.59, and 80%, respectively. Satisfactory clinical results were obtained for combined DIPS and IVC stenting for SOS associated with pyrrolizidine-alkaloid-related decompensated cirrhosis.

• 出版日期2018
• 单位中国人民解放军空军总医院; 温州医科大学