Clinical efficacy of transjugular intrahepatic portosystemic shunt created through left or right branches of the portal vein:A meta-analysis

• 作者: Shaobo Zhai Qi Cui Fang Dong Shiqi Wen Moubo Si Quan Chen
• 来源期刊: 介入医学杂志（英文）
• 年，卷（期）: 2021,（4）
• 所属期刊栏目: Clinical Study
• 页码范围: 190-196
• 页数: 7页
• 语种: 中文

摘要

Background and aim:Transjugular intrahepatic portosystemic shunt (TIPS) is a technique successfully used to treat portal hypertension and its complications.However,the choice of the branch,left (L) or right (R),of the portal vein resulting in a better outcome is still under debate.Therefore,this meta-analysis aims to evaluate which branch has a better curative effect on patients treated with TIPS.Methods:PubMed,EMBASE,Web of science,Cochrane Library databases,Wanfang database and CBM were used for our search in October 2019 and updated in June 2021.The following parameters were used in evaluation:overall mortality,hepatic encephalopathy,shunt dysfunction,variceal rebleeding and rate of postoperative ascites.Results:There were seven studies included.The sample size was 1940.A lower risk of mortality was observed in TIPS-L-treated patients compared with TIPS-R-treated ones (OR =0.65,95％ CI =0.50-0.85,p =0.002).A lower risk of shunt dysfunction was observed in TIPS-L-treated patients compared with TIPS-R-treated ones (OR =0.53,95％ CI =0.33-0.87,p =0.01).And the TIPS-L group had a significantly higher hepatic encephalopathy-free rate than the TIPS-R group (OR =0.59,95％ CI =0.44-0.78,p =0.0002).However,the rate of rebleeding(OR =0.75,95％ CI =0.55-1.03,p =0.07) and incidence of postoperative ascites (OR =1.14,95％CI =0.86-1.51,p =0.38) was not statistically significant between the two groups.Conclusions:Based on the currently available evidence,the technique of TIPS through the left branch of the portal vein can significantly reduce the occurrence of overall postoperative mortality,hepatic encephalopathy and shunt dysfunction.