transjugular intrahepatic portosystemic stent-shunt

transjugular intrahepatic portosystemic stent-shunt

TIPS Hepatology A minimally invasive portosystemic shunt for portal HTN and bleeding complications due to liver disease–eg, esophageal varices Indications Esophageal varices that bleed after endoscopic banding, sclerotherapy, or surgical portosystemic shunt; refractory ascites, hepatic venoocclusive disease or Budd-Chiari syndrome Complications Hemorrhage, stenosis, occlusion–intraabdominal, biliary, subcapsular; stent migration, contrast-induced renal failure, pulmonary edema, hepatic infarction, hepatic arterial injury, gallbladder puncture, stent malpositions, hemobilia, hemolysis, fever, sepsis, hemoperitoneum, radiation injury, entry site hematoma, subcapsular hematoma, encephalopathy, liver failure Outcome Hepatic encephalopathy 25%; 18% rebleed at 1 yr; 85% one-yr survival
References in periodicals archive ?
Long term outcome after transjugular intrahepatic portosystemic stent-shunt in non-transplant cirrhotics with hepatorenal syndrome: a phase II study.
Therapies that are used to assist in managing refractory ascites include large-volume paracentesis, and transjugular intrahepatic portosystemic stent-shunts (TIPS) (Gines, Cardenas, Arroyo, & Rodes, 2004; Saadeh & Davis, 2004; Sandhu & Sanyal, 2005; Sargent, 2006).
A review of randomized clinical trials comparing transjugular intrahepatic portosystemic stent-shunts with paracentesis concluded that TIPS was more effective at removing ascites without an increase in mortality (Saab, Nieto, Ly, & Runyon, 2006).