[Transjugular intrahepatic portosystemic shunt for portal hypertension]

Transjugular intrahepatic portosystemic shunt is a treatment for complications of portal hypertension, such as bleeding gastroesophageal varices and refractory ascites. In this article we reveal our experiences with this treatment modality.

All patients who had a transjugular intrahepatic portosystemic shunt inserted in the period 2011 - 2021 at Oslo University Hospital Ullevål were studied retrospectively. The cumulative incidence of death was calculated with liver transplantation as a competing event.

The procedure was technically successful in 62 of 64 patients. The average reduction of the pressure gradient between the inferior vena cava and the portal vein was 12.7 (standard deviation 5.0) mm Hg. One of 31 patients who underwent the procedure because of gastrointestinal bleeding experienced a new episode of bleeding, and 4 of 29 patients who underwent the procedure because of ascites needed a further one to two paracenteses. Two of 62 patients had complications directly related to the procedure in the form of liver abscess and portal vein thrombosis. Five of 62 patients developed symptoms of heart failure or fluid overload. After one, three and twelve months, 49 of 62 (79 %), 45 of 62 (73 %) and 38 of 62 (61 %) patients respectively were still alive. The procedure functioned as a 'bridge to liver transplantation' for eight patients with refractory ascites.

Transjugular intrahepatic portosystemic shunt is a useful treatment method for complications of portal hypertension.