TIPS for management of portal-hypertension-related complications in patients with cirrhosis

Publication date: Available online 26 October 2019Source: Clinics and Research in Hepatology and GastroenterologyAuthor(s): Manon Allaire, Aurélie Walter, Olivier Sutter, Pierre Nahon, Nathalie Ganne-Carrié, Roland Amathieu, Jean-Charles NaultSummaryPortal hypertension is primarily due to liver cirrhosis, and is responsible for complications that include variceal bleeding, ascites and hepatorenal syndrome. The transjugular intrahepatic portosystemic shunt (TIPS) is a low-resistance channel between the portal vein and the hepatic vein, created by interventional radiology, that aims to reduce portal pressure. TIPS is a potential treatment for severe portal-hypertension-related complications, including esophageal and gastric variceal bleeding. TIPS is currently indicated as salvage therapy in this setting when patients fail to respond to standard endoscopic and medical treatment. More recently, early TIPS has been shown to be effective in decreasing risk of rebleeding after variceal hemorrhage and mortality in Child-Pugh B patients with active hemorrhage at endoscopy, and in Child-Pugh C patients. TIPS is also an efficient treatment for refractory ascites and hepatic hydrothorax. In contrast, the role of TIPS in the hepatorenal syndrome has not been precisely defined. The aim of this review was to specifically describe the current role of TIPS in management of portal hypertension in patients with cirrhosis.
Source: Clinics and Research in Hepatology and Gastroenterology - Category: Gastroenterology Source Type: research