To evaluate the effect of transjuaular intrahepatic portosystemic stent shunt (TIPSS) in the treatment of senile cirrhosis and portal hypertension.

A retrospective analysis was reviewed on the 119 elder patients with senile cirrhosis and esophageal varices bleeding and refractory ascites. All of them underwent TIPSS after medical treatment fails. They were strictly followed up for 2 years and their clinical data were analysed. Color doppler imaging and shunt angiography were used to follow up patients to analyze the cases and type of stenosis.

All patients were successfully implanted with stents (75 cases with the fluency stents, 44 cases with bare-metal stents)to establish shunt. Portal venous pressure from before TIPSS (35.00±6.55) cmH₂O to after TIPSS (20.92±6.63) cmH₂O(t=13.43, P<0.01). There is a significant difference. TIPSS after 3 months, 6 months, 12 months and 24 months ascites complete or partial remission rates were 82.35%, 84.85%, 85.19% and 76.00%, rebleeding rates were 5.49%, 12.94%, 22.72% and 33.33%, incidence of shunt stenosis were 4.27%, 10.00%, 14.28% and 24.19%. After 2-year follow-up, the bare stent group had 47.73% stenosis; the covered stent group had 17.33% (χ²=12.55, P<0.01). The difference between two groups was statistically significant.

TIPSS is available and satisfactory in the treatment of senile cirrhosis and portal hypertension, which has high efficacy. TIPSS is less invasive, takes shorter operation tim, causes fewer complications. Stenosis rate can be significantly decreased by the application of covered stent in TIPSS.