Prevalence, clinical characteristics, and outcomes of spontaneous portosystemic shunt in patients with hepatitis B-related cirrhosis: A multicenter study from China

Qiao Ke; Xueping Yu; Xuan Wang; Jinfa Huang; Biding Lin; Jian He; Zhiyong Wang; Xinhui Huang; Xiadi Weng; Yubin Jiao; Yixing Xie; Weimin Wu; Linbin Qiu; Ling Li; Zhengju Xu; Zhijun Su; Yuzhen Zhuge; Jingfeng Liu; Wuhua Guo

doi:10.1016/j.dld.2023.04.012

Prevalence, clinical characteristics, and outcomes of spontaneous portosystemic shunt in patients with hepatitis B-related cirrhosis: A multicenter study from China

Dig Liver Dis. 2023 Oct;55(10):1382-1390. doi: 10.1016/j.dld.2023.04.012. Epub 2023 May 9.

Authors

Qiao Ke¹, Xueping Yu², Xuan Wang³, Jinfa Huang⁴, Biding Lin⁵, Jian He⁶, Zhiyong Wang⁶, Xinhui Huang⁶, Xiadi Weng⁶, Yubin Jiao⁶, Yixing Xie⁶, Weimin Wu⁶, Linbin Qiu⁶, Ling Li⁶, Zhengju Xu⁴, Zhijun Su², Yuzhen Zhuge⁷, Jingfeng Liu⁸, Wuhua Guo⁹

Affiliations

¹ Department of Interventional Radiology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian, China; Department of Hepatopancreatobiliary Surgery, Clinical Oncology School of Fujian Medical University, Fuzhou, Fujian, China.
² Department of Infectious Disease, The First Hospital of Quanzhou, affiliated to Fujian Medical University, Quanzhou, Fujian, China.
³ Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
⁴ The Liver Disease Center, The 910th Hospital of the PLA Joint Logistics Support Force, Quanzhou, Fujian, China.
⁵ Department of Infectious Disease, Fuding Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuding, Fujian, China.
⁶ Department of Interventional Radiology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian, China.
⁷ Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China. Electronic address: yuzheng9111963@aliyun.com.
⁸ Department of Interventional Radiology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian, China; Department of Hepatopancreatobiliary Surgery, Clinical Oncology School of Fujian Medical University, Fuzhou, Fujian, China. Electronic address: drjingfeng@126.com.
⁹ Department of Interventional Radiology, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, Fujian, China. Electronic address: guowuhua@aliyun.com.

PMID: 37164894
DOI: 10.1016/j.dld.2023.04.012

Abstract

Background: The impact of spontaneous portosystemic shunt (SPSS) on decompensated events and mortality for patients with hepatitis B-related cirrhosis remains poorly investigated.

Aims: To evaluate the prevalence, clinical characteristics, and outcomes of SPSS among patients with hepatitis B-related cirrhosis.

Methods: Patients who were diagnosed with hepatitis B-related cirrhosis were retrospectively recruited. All eligible patients were classified into SPSS and non-SPSS groups and their clinical characteristics and outcomes were compared and analyzed.

Results: Of the 1282 patients included in this study, SPSS was identified in 488 patients (38.1%). SPSS group had more severe liver function impairment, higher prevalence and severity of esophageal and gastric varices (EGV), and a higher prevalence of EGV bleeding (EGVB), portal vein thrombosis (PVT), hepatic encephalopathy (HE), ascites, and hepatocellular carcinoma (HCC, all P<0.05). During the follow-up period, SPSS group experienced a significantly higher incidence of EGVB, PVT, and HE (all P<0.05); however, there was no significant difference in the incidence of ascites, HCC, and mortality between the two groups (all P>0.05).

Conclusion: With hepatitis B-related cirrhosis, SPSS was common and characterized by severe liver damage and a high prevalence of decompensated events. Moreover, patients with SPSS had higher risks of EGVB, PVT, and HE.

Keywords: Collaterals; Decompensated event; Liver function; Portal hypertension; Prognosis.