Clinical study of modified partial splenic artery embolization in the treatment of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt

Objective To observe the effect of modified partial splenic artery embolization(MPSE) in the treatment of hepatic encephalopathy after transjugular intrahepatic portosystemic shunt(TIPS).

Methods A retrospective analysis was performed for 10 patients with hepatic encephalopathy after TIPS treated with MPSE. Liver function indexes, main portal vein flow velocity and shunt flow velocity were compared before and 3 and 6 months after operation were compared.

Results All patients successfully completed the MPSE, and postoperative symptoms of abdominal pain occurred in 1 case, but no obvious surgery-related symptoms and complications were found in other cases. During the six-month postoperative follow-up, only 1 case of hepatic encephalopathy was not controlled. There were no significant differences in alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), albumin (ALB) and main portal vein blood flow velocity at 3 and 6 months after operation (P>0.05). There were significant differences in shunt flow velocity 3 and 6 months after operation (P < 0.05).

Conclusion MPSE can reduce the shunt blood flow velocity after TIPS, and has the functions of flow limiting, thereby effectively controlling hepatic encephalopathy.