TIPS for refractory ascites: neither hemlock nor panacea. The Montreal experience and review of the literature.
Refractory ascites worsens the end-stage course of decompensated cirrhosis. Transjugular intrahepatic portasystemic shunt (TIPS) has been proposed to treat this condition with erratic success, inducing controversial reports on the risk-benefit ratio associated to this technique. In order to assess the usefulness of TIPS for this indication, this paper updates some definitions concerning the refractory ascites. We also analyze the main complications of TIPS and review some physiopathological pathways, taking peculiar interest in the Montreal experience.
Martinet
J P
JP
Service de Gastro-Entérologie, UCL University Hospital of Mont-Godinne, Belgium.
Pomier-Layrargues
G
G
D001201:Ascites / Q000503:physiopathology / Q000601:surgery*; D001775:Blood Circulation; D002908:Chronic Disease; D006321:Heart / Q000503:physiopathology; D006501:Hepatic Encephalopathy / Q000503:physiopathology; D006801:Humans; D017093:Liver Failure / Q000503:physiopathology; D009318:Natriuresis; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects; D016896:Treatment Outcome