Is the role of transjugular intrahepatic portosystemic shunts limited in the management of patients with end-stage liver disease?

Jameson Forster, Edward L. Siegel, Romano Delcore, K. Mark Payne, Jacqueline Laurin, James D. Kindscher

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Transjugular intrahepatic portosystemic shunts (TIPS) are an established method for the treatment of the complications of portal hypertension. Recent reports have suggested that TIPS require frequent follow-up and may interfere with orthotopic liver transplantation (OLT). METHODS: Retrospective chart review was performed of ultrasound studies, angiographic studies, and complications of the first 100 patients treated consecutively with TIPS from February 1992 through October 1995. RESULTS: Ninety-seven patients had functional TIPS. Thirty-one percent of patients treated emergently survived, significantly less than the 96% survival of elective patients. Fifty percent of the shunts were found to require angioplasty by 5 months. Seventeen patients treated with OLT did well, without intraoperative bleeding problems, and are alive. CONCLUSIONS: The TIPS method treats successfully the complications of portal hypertension but requires careful follow-up. The technique may be used prior to OLT. For non- OLT candidates, the cost effectiveness of TIPS versus surgical shunting remains in question.

Original languageEnglish (US)
Pages (from-to)536-540
Number of pages5
JournalAmerican journal of surgery
Volume172
Issue number5
DOIs
StatePublished - Nov 1 1996
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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