Transjugular intrahepatic portosystemic shunt in our own modification (Case series preliminary report)

Optimization of the technique of shunt placement in the most appropriate anatomical area and subsequent early postoperative management of the patient is aimed to facilitate their elimination of potentially preventable causes of re-admissions for ascites, hydrothorax, and bleeding from esophageal varices after performing TIPS. The use of the proposed methodological approaches made it possible to select the optimal localization of the portal vein branch puncture point, and contributed to the prevention of technical failures and complications of this stage of the operation. In our opinion, the use of autohemomagnetotherapy in the early postoperative period helped prevent the progression of hepatic encephalopathy and early shunt thrombosis.Preliminary analysis of the results of TIPS in our own modification.This article provides the results of TIPS performed to five patients in our own modification. A distinctive feature of our technique at the stage of portal vein puncture was the choice of the optimal point of its localization based on the anatomical variant of the divergence of the right anterior branch of the portal vein. Autohemomagnetotherapy was performed daily for 5 days in the postoperative period. All patients successfully underwent surgery. Recurrence of ascites and episodes of bleeding from esophageal varicose veins were not observed during postoperative follow-up of these patients for a period of 17 to 32 months. Regression of the size of varices was observed in all patients during endoscopic examination one year later. The reproducibility of the surgical intervention, its effectiveness and safety should be noted. It is advisable to carry out further studies of the effectiveness of the technique in randomized controlled trials.

liver cirrhosis, portal hypertension, esophageal varices, TIPS, autohemomagnetotherapy

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