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Esophageal varices. II. TIPS (transjugular intrahepatic portosystemic shunt) and surgical therapy
1Department of Medicine, Medical College of Virginia Commonwealth University, Richmond, USA. vluketic@hsc.vcu.edu
Gastroenterology Clinics of North America
|June 3, 2000
Abstract:
The role of surgery in the prevention and treatment of variceal hemorrhage is reviewed. Types of available surgery, their physiologic basis, and literature supporting their use are discussed in the context of the natural history of variceal hemorrhage. The evolution of transjugular intrahepatic portosystemic shunt (TIPS) as a treatment modality for variceal hemorrhage is reviewed. The effects of TIPS on portal and systemic hemodynamics and clinical usefulness in the management of variceal hemorrhage are discussed. A treatment algorithm for the integrated use of the various treatments is provided.