Abstract
Purpose: Transjugular intrahepatic portosystemic shunt (TIPS) has been reported superior to large-volume paracentesis for refractory ascites, but post-TIPS encephalopathy is a major complication. We intended to assess the outcome of limited diameter TIPS on ascites control, mortality, and encephalopathy in patients with refractory ascites at our centre. Methods: TIPS was successfully performed on 56 patients. Initial stent dilatation was to 6 mm, if there was a reduction in portal pressure gradient (PPG) >25%, further dilatation was not proposed. Results: Either complete or partial response was obtained in 58%, 81%, 83%, and 93% of patients at 1, 3, 6, and 12 months, respectively. Mortality was 10%, 29%, 37%, and 50% at 1, 3, 6, and 12 months, respectively. In 27 patients (48%), a new episode of encephalopathy developed, but only 6 (22%) were grade III or IV and 23 (85%) responded quickly to treatment. Conclusions: The results of our study confirm the efficacy of TIPS for refractory ascites. The use of narrow-diameter dilatation without aiming at lowering the PPG below a certain threshold might simplify the procedure and the follow-up for these patients.
| Original language | English |
|---|---|
| Pages (from-to) | 1089-1095 |
| Number of pages | 7 |
| Journal | Journal of Gastroenterology |
| Volume | 44 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - 2009 |
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Keywords
- Encephalopathy
- Portal hypertension
- Refractory ascites
- TIPS
ASJC Scopus subject areas
- Gastroenterology
Cite this
TIPS for refractory ascites : A single-centre experience. / Thalheimer, Ulrich; Leandro, Gioacchino; Samonakis, Dimitrios N.; Triantos, Christos K.; Senzolo, Marco; Fung, Konrad; Davies, Neil; Patch, David; Burroughs, Andrew K.
In: Journal of Gastroenterology, Vol. 44, No. 10, 2009, p. 1089-1095.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - TIPS for refractory ascites
T2 - A single-centre experience
AU - Thalheimer, Ulrich
AU - Leandro, Gioacchino
AU - Samonakis, Dimitrios N.
AU - Triantos, Christos K.
AU - Senzolo, Marco
AU - Fung, Konrad
AU - Davies, Neil
AU - Patch, David
AU - Burroughs, Andrew K.
PY - 2009
Y1 - 2009
N2 - Purpose: Transjugular intrahepatic portosystemic shunt (TIPS) has been reported superior to large-volume paracentesis for refractory ascites, but post-TIPS encephalopathy is a major complication. We intended to assess the outcome of limited diameter TIPS on ascites control, mortality, and encephalopathy in patients with refractory ascites at our centre. Methods: TIPS was successfully performed on 56 patients. Initial stent dilatation was to 6 mm, if there was a reduction in portal pressure gradient (PPG) >25%, further dilatation was not proposed. Results: Either complete or partial response was obtained in 58%, 81%, 83%, and 93% of patients at 1, 3, 6, and 12 months, respectively. Mortality was 10%, 29%, 37%, and 50% at 1, 3, 6, and 12 months, respectively. In 27 patients (48%), a new episode of encephalopathy developed, but only 6 (22%) were grade III or IV and 23 (85%) responded quickly to treatment. Conclusions: The results of our study confirm the efficacy of TIPS for refractory ascites. The use of narrow-diameter dilatation without aiming at lowering the PPG below a certain threshold might simplify the procedure and the follow-up for these patients.
AB - Purpose: Transjugular intrahepatic portosystemic shunt (TIPS) has been reported superior to large-volume paracentesis for refractory ascites, but post-TIPS encephalopathy is a major complication. We intended to assess the outcome of limited diameter TIPS on ascites control, mortality, and encephalopathy in patients with refractory ascites at our centre. Methods: TIPS was successfully performed on 56 patients. Initial stent dilatation was to 6 mm, if there was a reduction in portal pressure gradient (PPG) >25%, further dilatation was not proposed. Results: Either complete or partial response was obtained in 58%, 81%, 83%, and 93% of patients at 1, 3, 6, and 12 months, respectively. Mortality was 10%, 29%, 37%, and 50% at 1, 3, 6, and 12 months, respectively. In 27 patients (48%), a new episode of encephalopathy developed, but only 6 (22%) were grade III or IV and 23 (85%) responded quickly to treatment. Conclusions: The results of our study confirm the efficacy of TIPS for refractory ascites. The use of narrow-diameter dilatation without aiming at lowering the PPG below a certain threshold might simplify the procedure and the follow-up for these patients.
KW - Encephalopathy
KW - Portal hypertension
KW - Refractory ascites
KW - TIPS
UR - http://www.scopus.com/inward/record.url?scp=70350023219&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=70350023219&partnerID=8YFLogxK
U2 - 10.1007/s00535-009-0099-6
DO - 10.1007/s00535-009-0099-6
M3 - Article
VL - 44
SP - 1089
EP - 1095
JO - Journal of Gastroenterology
JF - Journal of Gastroenterology
SN - 0944-1174
IS - 10
ER -