经皮穿刺直接性门腔静脉分流术

Percutaneous direct intrahepatic portacaval shunt

直接性门腔分流(DIPS)是在肝后段下腔静脉与门脉之间建立肝内分流,将部分门脉血液直接分流入粗大的下腔静脉,解决了TIPS术后分流道引流静脉———肝静脉易狭窄或闭塞的缺陷。DIPS扩大了介入性门腔分流适应证,使部分难以实施TIPS术的患者也能做介入性门腔分流。由于DIPS分流道内的血流方向与下腔静脉内的血流方向呈锐角,局部血流动力学的改变较小。与TIPS相比术后并发症、近期疗效及分流通畅性无显著差异,但DIPS远期通畅性可能较TIPS术稳定。为此,DIPS术已成为近年来介入性门腔分流的新热点。

Direct intrahepatic portacaval shunt （DIPS） is created between the retrohepatic IVC and portal vein intrahepatically, with partial portal flow shunted directly to the IVC. DIPS can eliminate the defect that the outflow vein--hepatic vein is vulnerable to stenosis or occlusion after TIPS. DIPS has expanded the indication of interventional portacaval shunt, even in partial patients which TIPS can not be carried out. The inclination between the flow direction in the shunts and in the IVC is an acute angle, small changes will happen in regional hemodynamics. The complications, treatment effectiveness, and shunt patency in short-term has no significant difference between DIPS and TIPS, but the long-term patency in DIPS could be stable than that in TIPS. So the application of DIPS becomes a hot topic in recent years.