M. Ohta et al., COMPLICATIONS OF PERCUTANEOUS TRANSHEPATIC CATHETERIZATION OF THE PORTAL VENOUS SYSTEM IN PATIENTS WITH PORTAL-HYPERTENSION, Journal of gastroenterology and hepatology, 11(7), 1996, pp. 630-634
We report here complications of percutaneous transhepatic catheterizat
ion of the portal venous system in 170 Japanese patients with portal h
ypertension. All patients underwent percutaneous transhepatic portogra
phy and percutaneous transhepatic obliteration of oesophagogastric var
ices was also performed in 29 patients. After retraction of the cathet
er, the puncture canal was plugged with gelatin sponge in 150 subjects
and with one steel coil in 20 others. The overall complication rate w
as 16.5%. Intraperitoneal bleeding occurred in 10.6% of patients and 2
.9% required blood transfusion. In these patients with intraperitoneal
bleeding, the gelatin sponge was used for plugging after retraction o
f the catheter, while in the 20 patients with a steel coil plug, haemo
peritoneum never occurred. Right pleural effusion was recognized in 3.
5% of patients, intraperitoneal bile leakage in 1.8% and deterioration
of liver function due to arteriovenous fistula in 0.6%. By univariate
and multivariate analyses, female gender was the only risk factor for
intraperitoneal bleeding among 150 patients investigated by percutane
ous transhepatic catheterization of the portal venous system with gela
tin sponge plugging. Intraperitoneal bleeding is the most important co
mplication in patients with portal hypertension; it is difficult to pr
edict intraperitoneal bleeding before retraction of the catheter in pa
tients for whom gelatin sponge is used. Thus, for patients undergoing
percutaneous transhepatic catheterization of the portal venous system,
close follow up is recommended.