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KMID : 0386119920280030393
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Journal of the Korean Radiological Society
1992 Volume.28 No. 3 p.393 ~ p.398
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Transjugular Intrahepatic Portosystemic Shunt
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Abstract
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As a new interventional procedure for the control of variceal bleeding, a portosystemic shunt can be established with the installment of metallic stent through the transjugular approach. In order to evaluate the clinical usefulness of the
procedure,
transjugular intrahepatic portosystemic chunt procedure were performed in 5 patients with variceal bleeding due to liver cirrhosis. The metallic stents were mainly a self expandable Wallstent(Schneider, Switzerland). An 8 to 10 mm shunt was
formed
by
the insertion of the stent and balloon dilatation after puncture of the proximal portal vein from the right or middle hepatic vein. The patency of the shunt was proven by portography after the procedure. The portal pressure measured in 3 patients
before
and after the procedure improved with decrease from 31 mmHg to 25 mmHg. The procedure failed in 1 patient due to preexsisting portal vein thrombosis. During the follow-up period from 1 month to 4 months, shunts were patent in all 4 patients.
However,
hepatic encephalopathy occured in one patient one week following the procedure.
Though the follow-up period was not long enough for full evaluation. We found the transjugular intrahepatic portosystemic shunt was a safe and effective procedure for the control of variceal bleeding by lowering the portal pressure. For the
appropriate
application for this procedure, the optimal size of the shunt and optimal degree of the resultant decompression are yet to be determined in the future.
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