Patient Selection in Transjugular Intrahepatic Portosystemic Shunt (TIPS) for Refractory Ascites and Associated Conditions

被引：3
作者：
Kok B. [1 ]
Abraldes J.G. [1 ]
机构：
[1] Division of Gastroenterology (Liver Unit), University of Alberta Hospital, 1-40 Zeidler Ledcor Building, Edmonton, T6G-2X8, AB
来源：
Current Hepatology Reports | 2019年 / 18卷 / 2期
关键词：
Hepatic hydrothorax; Hepatorenal syndrome; Refractory ascites; Transjugular intrahepatic portosystemic shunt;
D O I：
10.1007/s11901-019-00470-4
中图分类号：
学科分类号：
摘要：
Purpose of Review: This review summarizes the key developments and latest evidence for transjugular intrahepatic portosystemic shunt (TIPS) for the indications of refractory ascites and related conditions, as well as factors that should be taken into consideration with regard to patient selection. Recent Findings: Recent evidence from randomized controlled studies has suggested that the early institution of TIPS in well-selected patients with refractory ascites may confer a survival benefit. Increasing evidence is also mounting on the potential role of TIPS in improving and reversing hepatorenal syndrome. Summary: TIPS has conventionally been sought as a second-line treatment for refractory ascites. Recent evidence has suggested a potential survival benefit with early TIPS in well-compensated patients for this indication; this may lead to a paradigm shift for TIPS to be considered as primary therapy in well-selected “low-risk” patients. In hepatorenal syndrome, while evidence on TIPS is limited, multiple studies have shown a serendipitous improvement to renal function in both type 1 and 2 hepatorenal syndrome following TIPS. © Springer Science+Business Media, LLC, part of Springer Nature 2019.
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页码：197 / 205
页数：8
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