Work

经皮实时超声引导经颈静脉肝内门体分流术的初步研究

Year: 2026

Type: article

Abstract: Objective To explore the effectiveness, safety profile, and preliminary clinical experience of percutaneous real-time ultrasound guidance in assisting portal vein puncture during a transjugular intrahepatic portosystemic shunt (TIPS) procedure. Methods A retrospective analysis was conducted on the data of 15 cases who underwent percutaneous ultrasound-guided transjugular intrahepatic portosystemic shunt (TIPS) at Nanjing Drum Tower Hospital from March 2024 to July 2025. Portal vein puncture was assisted by percutaneous real-time ultrasound guidance during the procedure. The technical success rate, number of puncture attempts, radiation exposure, complications, and clinical follow-up outcome status were analyzed. Measurement data with a normal distribution were described as [Image: see text] ±s, and measurement data with a non-normal distribution were described as M (Q(1), Q(3)).Categorical data were described using composition ratios. Results A total of 15 cases were enrolled, with a technical success rate of 15/15. The average number of puncture needles used was 2.7±1.5. The median radiation exposure time was 12.55 (9.78, 21.21) minutes, and the median dose-area product was 86.44 (62.46, 159.57) Gy·cm². Three patients experienced puncture-related injuries, including one case of biliary injury, one case of hepatic artery injury, and one case of hepatic capsule visualization, but none showed clinical manifestations. Postoperative follow-up for three months revealed no patient deaths, no rebleeding, and no shunt failure, but there was an occurrence of hepatic encephalopathy in four cases. Conclusion Percutaneous real-time ultrasound-assisted portal vein puncture during TIPS is feasible and safe, and it may help reduce the number of puncture attempts and minimize radiation exposure.

Source: PubMed Central

DOI: 10.3760/cma.j.cn501113-20251025-00454