TIPS for refractory ascites: A single-centre experience

Ulrich Thalheimer, Gioacchino Leandro, Dimitrios N. Samonakis, Christos K. Triantos, Marco Senzolo, Konrad Fung, Neil Davies, David Patch, Andrew K. Burroughs

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)1089-1095
Number of pages7
JournalJournal of Gastroenterology
Volume44
Issue number10
DOIs
Publication statusPublished - 2009

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Keywords

  • Encephalopathy
  • Portal hypertension
  • Refractory ascites
  • TIPS

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Thalheimer, U., Leandro, G., Samonakis, D. N., Triantos, C. K., Senzolo, M., Fung, K., Davies, N., Patch, D., & Burroughs, A. K. (2009). TIPS for refractory ascites: A single-centre experience. Journal of Gastroenterology, 44(10), 1089-1095. https://doi.org/10.1007/s00535-009-0099-6