title: TIPS for refractory ascites: a single-centre experience.
abstract: OBJECTIVE
  Transjugular intrahepatic portosystemic shunt (TIPS) has been reported superior to large-volume paracentesis for refractory ascites, but post-TIPS encephalopathy is a major complication. We intended to assess the outcome of limited diameter TIPS on ascites control, mortality, and encephalopathy in patients with refractory ascites at our centre.
  
  
  METHODS
  TIPS was successfully performed on 56 patients. Initial stent dilatation was to 6 mm, if there was a reduction in portal pressure gradient (PPG) >25%, further dilatation was not proposed.
  
  
  RESULTS
  Either complete or partial response was obtained in 58%, 81%, 83%, and 93% of patients at 1, 3, 6, and 12 months, respectively. Mortality was 10%, 29%, 37%, and 50% at 1, 3, 6, and 12 months, respectively. In 27 patients (48%), a new episode of encephalopathy developed, but only 6 (22%) were grade III or IV and 23 (85%) responded quickly to treatment.
  
  
  CONCLUSIONS
  The results of our study confirm the efficacy of TIPS for refractory ascites. The use of narrow-diameter dilatation without aiming at lowering the PPG below a certain threshold might simplify the procedure and the follow-up for these patients.
authors: The Sheila Sherlock Hepatobiliarypancreatic and Liver Transplantation Unit, Royal Free Hospital, Pond Street, London NW3 2QG, UK.
authors: Ulrich
authors: U
authors: Thalheimer
authors: Gioacchino
authors: G
authors: Leandro
authors: Dimitrios N
authors: DN
authors: Samonakis
authors: Christos K
authors: CK
authors: Triantos
authors: Marco
authors: M
authors: Senzolo
authors: Konrad
authors: K
authors: Fung
authors: Neil
authors: N
authors: Davies
authors: David
authors: D
authors: Patch
authors: Andrew K
authors: AK
authors: Burroughs
mesh_terms: D001201:Ascites / Q000209:etiology / Q000401:mortality / Q000517:prevention & control / Q000601:surgery*; D004106:Dilatation / Q000295:instrumentation / Q000379:methods*; D004932:Esophageal and Gastric Varices / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006501:Hepatic Encephalopathy / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D006975:Hypertension, Portal / Q000453:epidemiology; D008107:Liver Diseases / Q000150:complications / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019152:Paracentesis; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D011475:Prosthesis Failure; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome