Hepatic Encephalopathy in Patients with Liver Cirrhosis before and after TIPS

Aim. Optimization of the tactics of management of patients with liver cirrhosis who underwent Transjugular Intrahepatic Portosystemic Shunt – TIPS based on own experience and literature data. Materials and methods. From 2014 to 2019 years 51 Transjugular Intrahepatic Portosystemic Shunt procedures were performed. Results. The indications for Transjugular Intrahepatic Portosystemic Shunt procedure were detailed. The tactics of treatment in post-operative period was assessed. Shot-term and long-term results of the treatment were discussed. Especial attention was put to persons who included in patient list of liver transplantation. Conclusion. Transjugular Intrahepatic Portosystemic Shunt allows obtaining stable decompression in portal system that reduces frequency of bleeding relapse from gastric and esophageal veins. The mortality was decreased, and patients can wait till liver transplantation.

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Transjugular intrahepatic portosystemic stent-shunt as minimally invasive method of portal hypertension correction in multi-disciplinary clinic

Durleshter

Габриэль

Korochanskaya

et al. 2020

Ann. hir. gepatol.

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First experience of transjugular intrahepatic portosystemic shunting at multidisciplinary hospital with a liver transplantation program

et al. 2022

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Aim: Analysis of the first experience of transjugular intrahepatic portosystemic shunting (TIPS) in patients with liver cirrhosis at a multidisciplinary hospital with a liver transplantation program.Materials and methods: The authors examined 206 patients with liver cirrhosis from July 2019 to June 2021, with 20 of them undergoing TIPS. The mean age of the patients was 47.59 ± 9.55 years (35–65 years). Dynamic follow-up was performed at 3, 6, 9, 12, and 18 months. As a part of the dynamic follow-up, the patients underwent laboratory tests, abdomen ultrasound examination, and computed tomography imaging enhanced by the intravenous use of contrasting agent, endoscopy, esophagogastroduodenoscopy, and encephalopathy assessment.Results: No in-hospital TIPS-associated mortality has been reported. Two patients died in the hospital at the 19th and 26th day following the surgery because of the progression of liver failure, the 6-week mortality rate was 10%. In one patient (5%), an intraoperative complication was reported, i.e., intra-abdominal hemorrhage secondary to the migration of the stent under the liver capsule. The length of hospital stay after surgery was 7.34 ± 1.89 days (5–26 days). Long-term outcomes were available for 17 patients. The duration of the dynamic follow-up was 13.23 ± 2.47 months (3–24 months) and 2 (11,7%) deaths were reported. One patient (5.8%) was diagnosed with a shunt thrombosis at 12 months after the surgery. Three patients underwent liver transplantation after TIPS. The current one-year survival rate is 90%.Conclusion: TIPS is a safe and effective procedure decreasing mortality and improving quality of life of patients awaiting cadaveric liver transplantation. TIPS should be widely implemented in multidisciplinary hospitals having liver transplant program.

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Hepatic Encephalopathy in Patients with Liver Cirrhosis before and after TIPS

Cited by 2 publications

References 3 publications

Transjugular intrahepatic portosystemic stent-shunt as minimally invasive method of portal hypertension correction in multi-disciplinary clinic

Transjugular intrahepatic portosystemic stent-shunt as minimally invasive method of portal hypertension correction in multi-disciplinary clinic

First experience of transjugular intrahepatic portosystemic shunting at multidisciplinary hospital with a liver transplantation program

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