[Portosystemic anastomosis at the time of transplantation and TIPS]

Sclerotherapy has become in the treatment of acute haemorrhage of oesophageal varices the method of first choice. The relapse of haemorrhage within a five-year interval is however too frequent after this treatment. TIPS is a new method which can resolve profuse haemorrhage from varices in patients with a markedly reduced hepatic reserve. The high incidence of stenosis or occlusion (50% during the first six months) however foresees the use this method rather for bridging the interval before definite therapy i.e. transplantation of the liver. Patients with a sufficient functional hepatic reserve and those who are candidates for transplantation can be protected with a very good effect against relapsing haemorrhage by a surgical anastomosis.