Direct intrahepatic portocaval shunt for refractory hepatic hydrothorax: a case report

Kawahara, Yo; Tanaka, Yoshihiro; Isoi, Naoaki; Hatanaka, Kohsuke; Yamada, Kentaro; Yamamoto, Masayoshi; Okamura, Teppei; Kaji, Tatsuru; Sakamoto, Toshihisa; Saitoh, Daizoh; Ikeuchi, Hisashi

doi:10.1002/ams2.257

Cited by 3 publications

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References 6 publications

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“…DIPS has been mostly used for patients with Budd-Chiari syndrome in whom hepatic vein remnants cannot be cannulated. [161,162] In patients with cirrhosis, examples of anatomical conditions that may require DIPS include a particularly long intraparenchymal tract between the PV and the hepatic vein, presence of large obstacles between such as hepatic cysts or nodules, a distorted postsurgical anatomy, [163] a particularly severe stiffness of the liver parenchyma, [164] or a combination of these factors.…”

Section: Direct Intrahepatic Portocaval Shunt As a Technical Alternat...mentioning

confidence: 99%

The role of transjugular intrahepatic portosystemic shunt in patients with cirrhosis and ascites: Recent evolution and open questions

et al. 2022

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In selected patients with cirrhosis and ascites, transjugular intrahepatic portosystemic shunt (TIPS) placement improves control of ascites and may reduce mortality. In this review, we summarize the current knowledge concerning the use of TIPS for the treatment of ascites in patients with cirrhosis, from pathophysiology of ascites formation to hemodynamic consequences, patient selection, and technical issues of TIPS insertion. The combination of these factors is important to guide clinical decision-making and identify the best strategy for each individual patient. There is still a need to identify the best timing for TIPS placement in the natural history of ascites (recurrent vs. refractory) as well as which type and level of renal dysfunction is acceptable when TIPS is proposed for the treatment of ascites in cirrhosis. Future studies are needed to define the optimal stent diameter according to patient characteristics and individual risk of shunt-related side effects, particularly hepatic encephalopathy and insufficient cardiac response to hemodynamic consequences of TIPS insertion. How to cite this article: Deltenre P, Zanetto A, Saltini D, Moreno C, Schepis F. The role of transjugular intrahepatic portosystemic shunt in patients with cirrhosis and ascites: Recent evolution and open questions. Hepatology. 2022;00:1-19.

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