[TIPSS: technical and clinical results after 4 years].
OBJECTIVE
Retrospective analysis of the technical and clinical results after transjugular portosystemic stent shunt (TIPSS) procedure.


METHODS
Between 1992 and 1996 we tried to establish a TIPSS in 90 patients. The indications were: recurrent variceal haemorrhage (n = 74), refractory ascites (n = 12), hepatorenal syndrome (HRS) (n = 4). Due to advanced liver cirrhosis 16 patients suffered of severe renal dysfunction (HRS). 57 patients had ascites.


RESULTS
TIPSS implantation was technically successful in 96.7% (1992-1994: 5.1%, 1995-1996: 100%) of the patients. Complications occurred in 14.9% (1992-1994: 25.6%, 1995-1996: 6.3%). TIPSS-associated mortality was 2.3% (1992-1994: 5.1%, 1995-1996: 0%). 76.1% of the patients required reinterventions. 85.3% of reinterventions were necessary in the first year after TIPSS placement. The survival rate without reintervention was 28%, 21% and 9% for Child A, B, and C patients, respectively. Recurrent variceal haemorrhage occurred in 12.7%. De novo hepatic encephalopathy developed in 13.8%. Ascites improved in 79.2% and renal function in 75% of the patients.


CONCLUSIONS
TIPSS is an effective method to treat recurrent variceal haemorrhage, refractory ascites and HRS. Complication and mortality rate depend on the investigator's experience and on the technique used.
Textor
H J
HJ
Radiologische Universitätsklinik, Universität Bonn.
Brensing
K A
KA
Wilhelm
K
K
Strunk
H
H
Block
W
W
Raab
P
P
Hofer
U
U
Müller-Miny
H
H
Layer
G
G
Schiedermeier
P
P
Schüller
H
H
Sauerbruch
T
T
Schild
H H
HH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004932:Esophageal and Gastric Varices / Q000601:surgery; D005260:Female; D006530:Hepatorenal Syndrome / Q000601:surgery; D006801:Humans; D008103:Liver Cirrhosis / Q000401:mortality / Q000601:surgery; D008107:Liver Diseases / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000401:mortality; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
TIPSS: Technische und klinische Ergebnisse nach 4 Jahren.