A Comparison Of Treatment With Transjugular Intrahepatic Portosystemic Shunt Or Distal Splenorenal Shunt In The Management Of Variceal Bleeding Prior To Liver Transplantation

1995 ◽  
Vol 59 (2) ◽  
pp. 226-229 ◽  
Author(s):  
Marwan S. Abouljoud ◽  
Marlon F. Levy ◽  
Chet R. Rees ◽  
Norman G. Diamond ◽  
Stephen P. Lee ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Variceal Bleeding ◽  
Portosystemic Shunt ◽  
Splenorenal Shunt ◽  
Distal Splenorenal Shunt ◽  
Intrahepatic Portosystemic Shunt

scholarly journals Unsolved Questions in Salvage TIPSS: Practical Modalities for Placement, Alternative Therapeutics, and Long-Term Outcomes

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Charlotte Bouzbib ◽  
Philippe Sultanik ◽  
Dominique Thabut ◽  
Marika Rudler
Keyword(s):  
Liver Transplantation ◽  
Hepatic Encephalopathy ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Variceal Bleeding ◽  
Portosystemic Shunt ◽  
Recurrent Bleeding ◽  
Long Term Outcomes ◽  
Intrahepatic Portosystemic Shunt ◽  
Poor Outcomes

Salvage transjugular intrahepatic portosystemic shunt (TIPSS) has proven its efficacy to treat refractory variceal bleeding for patients with cirrhosis. However, this procedure is associated with very poor outcomes. As it is used as a last resort to treat a severe complication of cirrhosis, it seems essential to improve our practice, with the aim of optimizing management of those patients. Somehow, many questions are still unsolved: which stents should be used? Should a concomitant embolization be systematically considered? Is there any alternative therapeutic in case of recurrent bleeding despite TIPSS? What are the long-term outcomes on survival, liver transplantation, and hepatic encephalopathy after salvage TIPSS? Is this procedure futile in some patients? Is prognosis with salvage TIPSS nowadays as bad as earlier, despite the improvement of prophylaxis for variceal bleeding? The aim of this review is to summarize those data and to identify the lacking ones to guide further research on salvage TIPSS.

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