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[Intrahepatic portosystemic shunts]

M Grosso1, F Spalluto, A Veltri

  • 1Istituto di Radiologia, Università di Torino.

Minerva Chirurgica
|October 1, 1994
PubMed
Summary
This summary is machine-generated.

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Transjugular intrahepatic portosystemic shunt (TIPS) is a safe and effective treatment for portal hypertension. While shunt stenosis can occur, repeat interventions successfully manage complications like varices and ascites.

Area of Science:

  • Interventional Radiology
  • Hepatology
  • Gastroenterology

Background:

  • Portal hypertension is a serious complication of cirrhosis.
  • Digestive hemorrhage and intractable ascites are common indications for intervention.

Purpose of the Study:

  • To evaluate the safety and efficacy of Transjugular Intrahepatic Portosystemic Shunt (TIPS) in cirrhotic patients.
  • To assess outcomes and complications associated with the TIPS procedure.

Main Methods:

  • 98 TIPS procedures were performed in 97 cirrhotic patients between March 1992.
  • Indications included digestive hemorrhage (81 patients), ascites (13 patients), and bleeding prevention (3 patients).
  • Patients were monitored using US-Doppler and esophagogastroscopy.

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Main Results:

  • Immediate technical success rate was 96.9% (95/98).
  • Major complications included hepatic failure, renal insufficiency, and encephalopathy.
  • Shunt stenosis occurred in 23.1% (22/95) but was successfully managed in 21 patients via PTA or restenting.
  • Mortality rates varied by Child class: 0% (Child A), 14.5% (Child B), and 41.3% (Child C).

Conclusions:

  • TIPS is a safe and valuable treatment for portal hypertension.
  • While shunt stenosis is a known complication, reintervention is effective in managing gastro-oesophageal varices and ascites.