Transjugular intrahepatic portacaval shunt an experimental work

Rösch, Josef; Hanafee, William N.; Snow, Harold D.; Barenfus, Morris; Gray, R

doi:10.1016/0002-9610(71)90147-4

Cited by 125 publications

(37 citation statements)

References 4 publications

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“…Biliary puncture and fistula formation is also a rare complication, occurring with an incidence of less than 5% 107 . Fistula formation between the biliary and vascular systems could result in hemobilia, cholangitis, sepsis, and stent infection 1, 108 . If fistula formation occurs between a stent and the biliary system, early stent occlusion may ensue due to marked psuedointimal hyperplasia 109 .…”

Section: Complicationsmentioning

confidence: 99%

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Transjugular Intrahepatic Portosystemic Shunt

Patidar¹,

Sydnor²,

Sanyal³

2014

Clinics in Liver Disease

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Transjugular intrahepatic portosystemic shunt (TIPS) is an established procedure for the complications of portal hypertension. The largest body of evidence for its use has been supported for recurrent or refractory variceal bleeding and refractory ascites. Its use has also been advocated for acute variceal bleed, hepatic hydrothorax, and hepatorenal syndrome. With the replacement of bare metal stents with polytetrafluoroethylen (PTFE) covered stents, shunt patency has improved dramatically thus improving outcomes. Therefore, reassessment of its utility, management of its complications, and understanding of various TIPS techniques is important.

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Section: Complicationsmentioning

confidence: 99%

“…al 1 in 1979, is a percutaneous image guided procedure in which a tract or conduit is constructed within the liver between the systemic venous system and portal system with an intent for portal decompression (Figure 1) 2 . The most common conduit is between the right hepatic vein (HV) and the right portal vein (PV).…”

Section: Introductionmentioning

confidence: 99%

Transjugular Intrahepatic Portosystemic Shunt

Patidar¹,

Sydnor²,

Sanyal³

2014

Clinics in Liver Disease

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“…13,14 Trans-jugular intrahepatic portosystemic shunt (TIPS) was pioneered by Rösch. 15 Starzl and Calne introduced liver transplantation and revolutionized the management. 16,17 Transplant has offered treatment for patients with end-stage liver disease and portal hypertension.…”

Section: Introductionmentioning

confidence: 99%

Warren shunt - significance in present time, an experience at tertiary care hospital in India

et al. 2016

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INTRODUCTIONPortal hypertension is the presence of portal venous pressure more than 10 mm Hg. Esophagogastric varices do not bleed until portal pressure exceeds 12 mm Hg, and then they bleed in only one third to one half of patient. 1Portal hypertension was recognized by the Greeks and was highlighted by Shakespeare in his character of Falstaff.2,3 Surgery was the only treatment available for portal hypertension in the earlier times and the mortality rates were very high. In present times, about 10-15% of patients require surgery. With the development of the endoscopic treatment i.e. sclerotherapy, surgery no longer remains the first line of treatment in portal hypertension.Shunts have been attempted since 1877 wherein Eck ligated the portal vein and connected the visceral end to the vena cava. It commonly became known as Eck Fistula.4 Nicolai Eck was a Russian Army surgeon and performed an end-to-side portocaval shunt in an animal model. Vidal, a French surgeon is credited with performing the first portal systemic shunt in man in 1903. In mid-1940's a portocaval shunt was devised by Whipple and Blakemore and many other procedures were tried as mesocaval shunts by Drapanas, selective variceal decompression by Warren and Inochuchi and partial shunts by Sarfeh. [5][6][7][8][9] First sclerotherapy was done with rigid oesophagoscope. In the 1980s, three surgeons Johnston, Terblanche and Paquet turned from rigid to ABSTRACT Background: Portal hypertension is the presence of portal venous pressure more than 10 mm Hg. Surgery was the only treatment available for portal hypertension in the earlier times and the mortality rates were very high. In present times, about 10-15% of patients require surgery. Here we study the significance of the distal splenorenal shunt (Dean Warren shunt). Methods: We studied a total of 45 patients of portal hypertension admitted at SSKM Hospital, IPGMER, Kolkata, over a period of 5 years. This study includes the patients, ranging in age from 5 to 20 years and comprising of 5 women and 40 men. All patients were having non cirrhotic extra-hepatic portal. Results: All of the patients survived postoperatively and are in follow-up without any complication and doing well. Conclusions: Warren's shunt is a good alternative of liver transplantation, especially for the developing countries where the facilities for liver transplantation and post-operative care are not available or good enough. It has very good results and low complication rates.

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“…This technique was first mentioned in the literature in 1971 by Rösch et al [3]. They created T1PSS in dogs by introducing a spring coil tube between the portal vein and the inferior vena cava.…”

Section: Introductionmentioning

confidence: 99%

Transjugular Intrahepatic Portosystemic Stent Shunt: A 2-Year Follow-Up

Rössle¹,

Richter²,

Nöldge³

et al. 1992

Dig Surg

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Transjugular intrahepatic portosystemic stent shunt (TIPSS) is a new non-operative treatment of portal hypertension. The technique is based on the transjugular introduction of an expandable vascular stent which is implanted into the liver parenchyma between a main branch of the portal vein and a hepatic vein. Twelve patients with liver cirrhosis and recurrent variceal hemorrhage, who were excluded from operative treatment, were included in a pilot study. All patients either refused surgery or were considered poor surgical candidates. TIPSS was successfully established in 9 of the patients (75%). 58% of the patients survived 12 months and 50% 24 months. Variceal rebleeding occurred in 1 patient. Aggravation of hepatic encephalopathy was found in 1 patient. The results of this pilot study indicate that TIPSS controls variceal bleedings effectively during a follow-up of up to 2 years. It may be suitable for patients with advanced liver disease and high operative risk. It also does not limit later consideration for liver transplantation. During the course of the study, refinements of the technique have led to an even safer procedure which generally can be completed in 1 -2 h.

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Transjugular intrahepatic portacaval shunt an experimental work

Cited by 125 publications

References 4 publications

Transjugular Intrahepatic Portosystemic Shunt

Transjugular Intrahepatic Portosystemic Shunt

Warren shunt - significance in present time, an experience at tertiary care hospital in India

Transjugular Intrahepatic Portosystemic Stent Shunt: A 2-Year Follow-Up

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