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Related Concept Videos

Hepatic Portal System01:21

Hepatic Portal System

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The hepatic portal system, a critical part of our circulatory framework, transports nutrient-laden, deoxygenated blood from the gastrointestinal tract and spleen to the liver. This ingenious system plays an indispensable role in maintaining our body's metabolic equilibrium.
At its core, the hepatic portal vein is the result of a confluence of the superior and inferior mesenteric veins along with the splenic vein. Each of these veins has a unique role. The superior mesenteric vein is...
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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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Updated: Jul 16, 2025

Measurement of the Hepatic Venous Pressure Gradient and Transjugular Liver Biopsy
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New Indications for TIPSs: What Do We Know So Far?

Lucia Lapenna1, Simone Di Cola1, Jakub Gazda2

  • 1Department of Translational and Precision Medicine, Sapienza University of Rome, Italy.

Journal of Clinical and Experimental Hepatology
|September 11, 2023
PubMed
Summary
This summary is machine-generated.

Transjugular intrahepatic portosystemic shunt (TIPS) remains effective for portal hypertension. Emerging applications beyond traditional uses, including portal vein thrombosis and noncirrhotic conditions, show promise but require further research.

Keywords:
Budd-Chiari syndromeportal hypertensionportal vein thrombosissurgerytransjugular intrahepatic portosystemic shunt

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Area of Science:

  • Interventional Radiology
  • Hepatology
  • Vascular Surgery

Background:

  • Transjugular intrahepatic portosystemic shunt (TIPS) has been a cornerstone therapy for portal hypertension since 1988.
  • Technical advancements and improved patient selection have led to excellent outcomes with TIPS.
  • Established indications include refractory ascites and variceal bleeding in liver cirrhosis.

Purpose of the Study:

  • To review novel and emerging indications for TIPS.
  • To critically evaluate the role of TIPS in portal vein thrombosis, recurrent ascites, neoadjuvant therapy, and noncirrhotic portal hypertension.
  • To highlight areas for future research and validation of new TIPS applications.

Main Methods:

  • Literature review of existing studies on TIPS.
  • Analysis of clinical practice and outcomes for new indications.
  • Critical appraisal of evidence for emerging TIPS roles.

Main Results:

  • TIPS is increasingly explored for portal vein thrombosis, especially in liver transplant candidates.
  • Its use in recurrent ascites (beyond refractory) and as neoadjuvant therapy before surgery is under investigation.
  • The application of TIPS in noncirrhotic portal hypertension is also an emerging area.

Conclusions:

  • While traditional indications for TIPS are well-established, new applications are gaining traction.
  • Further research is essential to validate these emerging roles and potentially incorporate them into clinical guidelines.
  • TIPS continues to evolve as a versatile therapeutic option for complex portal hypertension scenarios.