TY - JOUR
T1 - Transjugular intrahepatic portosystemic shunts (TIPS)
AU - Kamath, Patrick S.
AU - Mckusick, Michael A.
PY - 1997/6
Y1 - 1997/6
N2 - Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure recently introduced for the management of complications of portal hypertension. TIPS can be-placed in the liver with relative ease by a skilled radiologist with a low risk of mortality. The major complications following the procedure are infection, especially in patients undergoing emergency TIPS, intra-abdominal haemorrhage from capsular punctures, and long-term problems related to encephalopathy and stenosis of the shunt. Encephalopathy is more of a problem in older patients with wide diameter shunts. Stenosis of the shunt is related to pseudo-intimal hyperplasia, probably related to transection of bile ductules during placement of the shunt. In view of the high rate of encephalopathy and stenosis following the shunt, a careful follow-up of all patients, including ultrasonographic and angiographic examination of the shunt, is mandatory. TIPS is used predominantly for the control of acute variceal haemorrhage, prevention of recurrent variceal bleeding, and refractory ascites when conventional treatment has failed. However, the role of TIPS in the management of complications of portal hypertension still awaits the outcome of clinical trials.
AB - Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure recently introduced for the management of complications of portal hypertension. TIPS can be-placed in the liver with relative ease by a skilled radiologist with a low risk of mortality. The major complications following the procedure are infection, especially in patients undergoing emergency TIPS, intra-abdominal haemorrhage from capsular punctures, and long-term problems related to encephalopathy and stenosis of the shunt. Encephalopathy is more of a problem in older patients with wide diameter shunts. Stenosis of the shunt is related to pseudo-intimal hyperplasia, probably related to transection of bile ductules during placement of the shunt. In view of the high rate of encephalopathy and stenosis following the shunt, a careful follow-up of all patients, including ultrasonographic and angiographic examination of the shunt, is mandatory. TIPS is used predominantly for the control of acute variceal haemorrhage, prevention of recurrent variceal bleeding, and refractory ascites when conventional treatment has failed. However, the role of TIPS in the management of complications of portal hypertension still awaits the outcome of clinical trials.
KW - Ascites
KW - Portal hypertension
KW - Portosystemic shunts
KW - Variceal haemorrhage
UR - http://www.scopus.com/inward/record.url?scp=0030781021&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0030781021&partnerID=8YFLogxK
U2 - 10.1016/S0950-3528(97)90043-9
DO - 10.1016/S0950-3528(97)90043-9
M3 - Article
C2 - 9395751
AN - SCOPUS:0030781021
SN - 0950-3528
VL - 11
SP - 327
EP - 349
JO - Bailliere's Clinical Gastroenterology
JF - Bailliere's Clinical Gastroenterology
IS - 2
ER -