[Intrahepatic porto-systemic shunt in the treatment of hemorrhage in portal hypertension].
PREVENT RECURRENT BLEEDING: Digestive hemorrhage due to portal hypertension is the cause of one-third of the mortality in cirrhosis. Transjugular intrahepatic portosystemic shunt (TIPS) creates a calibrated anastomosis between the portal vein and hepatic vein. The technique is now well established and a trained team can install a shunt in approximately 2 hours with a risk of failure of less than 10%.


RESULTS
TIPS can be effective for the treatment and prevention of variceal bleeding subsequent to portal hypertension. Preliminary results have not however provided the precise indications for this technique in the therapeutic armamentanium.


RESULTS
Hepatic encephalopathy and obstruction are the main complications. Encephalopathy can occur as an acute episode; frequency appears to fall off after endothelialization of the prosthesis. The degree of shunt obstruction can reach 40% at one year and remains the major problem with this technique. Its pathogenesis is unknown and there is no prevention. Regular surveillance is required to detect this complication and take the necessary steps.
Barange
K
K
Service d'Hépatro-Gastroentérologie, CHU Purpan, Toulouse.
Rousseau
H
H
Vinel
J P
JP
D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000601:surgery; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D012008:Recurrence
Le shunt intra-hépatique porto-systémique dans le traitement des hémorragies de l'hypertension portale.