Purpose: To analyze the effects of trans-jugular intrahepatic portosystemic shunt (TIPS) on portal hypertension and liver function in patients with hepatocellular carcinoma (HCC).
Materials and Methods: Thirteen patients with hemorrhage caused by portal hypertension and HCC who received TIPS and antitumor treatment were retrospectively analyzed. Trans-arterial chemoembolization, microwave ablation, target therapy, and immunetherapy or combined therapy were performed to treat HCC. Child-Pugh score was applied to estimate liver functions before and after TIPS. Shunting patency, overall survival (OS), and progression-free survival were analyzed.
Results: The median age was 58 (interquartile range: 52.5–62.5) years. The ratio with ascites before and after TIPS was 84.6% (11/13) and 7.7% (1/13), with P < 0.001. The ratio with Child-Pugh A before and after TIPS were 61.5% (8/13) and 84.6% (11/13) respectively, with P = 0.179. Mean portal vein pressure before and after TIPS was 27.85 ± 7.02 mmHg and 16.23 ± 6.61 mmHg, respectively, with P = 0.001. Two-year shunting patency rate was 61.5%. Median OS was 29.8 ± 11.5 months (95% confidence interval [CI] 22.8–36.7), and median progression-free survival was 20.2 ± 13.2 months (95% CI 12.2–28.1).
Conclusion: TIPS could reduce ascites, down-regulate the Child-Pugh score, and give a chance for further anti-tumor therapy.


中文翻译：

---

肝细胞癌患者经颈静脉肝内门体分流术的初步研究


目的：分析经颈静脉肝内门体分流术（TIPS）对肝细胞癌（HCC）患者门脉高压及肝功能的影响。
材料与方法：回顾性分析13例接受TIPS及抗肿瘤治疗的门静脉高压性出血合并HCC患者。经动脉化疗栓塞、微波消融、靶向治疗、免疫治疗或联合治疗治疗HCC。Child-Pugh 评分用于评估 TIPS 前后的肝功能。分析了分流通畅率、总生存期 (OS) 和无进展生存期。
结果：中位年龄为 58 岁（四分位距：52.5-62.5）岁。TIPS前后腹水比例分别为84.6%（11/13）和7.7%（1/13），P < 0.001。TIPS前后Child-Pugh A的比率分别为61.5%（8/13）和84.6%（11/13），P=0.179。TIPS 前后平均门静脉压力分别为 27.85 ± 7.02 mmHg 和 16.23 ± 6.61 mmHg，P = 0.001。两年分流通畅率为61.5%。中位 OS 为 29.8 ± 11.5 个月（95% 置信区间 [CI] 22.8-36.7），中位无进展生存期为 20.2 ± 13.2 个月（95% CI 12.2-28.1）。
结论： TIPS可减少腹水，下调Child-Pugh评分，为进一步抗肿瘤治疗提供机会。