Transjugular intrahepatic portosystemic shunt creation for the prevention of gastric variceal rebleeding in patients with hepatocellular carcinoma: a multicenter retrospective study.

Purpose To evaluate the effectiveness and safety of transjugular intrahepatic portosystemic shunt (TIPS) creation for the prevention of gastric variceal rebleeding in patients with Hepatocellular carcinoma (HCC). Materials and methods This multicenter retrospective study included 126 cirrhotic patients (mean age, 54.1 ± 10.2 years; 110 males) with HCC who underwent TIPS creation for the prevention of gastric variceal rebleeding. One hundred ten patients (87.3%) had gastroesophageal varices and 16 patients (12.7%) had isolated gastric varices. Thirty-five patients (27.8%) had portal vein tumor thrombus. Results TIPS creation was technically successful in 124 patients (98.4%). Rebleeding occurred in 26 patients (20.6%) during the follow-up period. The 6-week and 1-year actuarial probabilities of patients remaining free of rebleeding were 98.3 ± 1.2% and 81.2 ± 3.9%, respectively. Forty-nine patients (38.8%) died during the follow-up period. The 6-week and 1-year actuarial probabilities of survival were 98.4 ± 1.1% and 65.6 ± 4.4%, respectively. Two patients (1.6%) had major procedure-related complications, including acute liver failure (n = 1) and intra-abdominal bleeding (n = 1). Thirty-three patients (26.2%) had at least one episode of overt hepatic encephalopathy during the follow-up period. Shunt dysfunction occurred in 15 patients (11.9%) after a median follow-up time of 11.4 (range, 1.4-41.3) months. Lung metastasis occurred in three patients (2.4%) 3.9-32.9 months after TIPS creation. Conclusion TIPS creation may be effective and safe for the prevention of gastric variceal rebleeding in patients with HCC.