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Transjugular intrahepatic portosystemic shunt in the management of ascites and hepatorenal syndrome.
Eur J Gastroenterol Hepatol. 2006 Nov; 18(11):1143-50.EJ

Abstract

Ascites is the most common complication of liver cirrhosis and when it develops mortality is 50% at 5 years, apart from liver transplantation. Large volume paracentesis has been the only option for ascites refractory to medical treatment. The role of transjugular intrahepatic portosystemic shunt in the management of diuretic-resistant ascites has been evaluated in many cohort studies and five randomized trials up to now, clearly showing improvement in natriuresis and clinical efficacy. It, however, remains unclear how transjugular intrahepatic portosystemic shunt affects survival and quality of life, because hospital admissions owing to worsening encephalopathy may counterbalance the reduced need of paracentesis. What is clear is that the patient selection is critical. About 30% of patients with ascites develop hepatorenal syndrome at 5 years, leading to high mortality in its severe and progressive form. As its main pathogenetic factor is derangement of circulatory function owing to portal hypertension, these patients may benefit from transjugular intrahepatic portosystemic shunt, but this has been shown only in small series, in which mortality remains very high, owing to the underlying poor liver function.

Authors+Show Affiliations

Liver Transplantation and Hepatobiliary Unit, Royal Free & University College Medical School, London, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17033432

Citation

Senzolo, Marco, et al. "Transjugular Intrahepatic Portosystemic Shunt in the Management of Ascites and Hepatorenal Syndrome." European Journal of Gastroenterology & Hepatology, vol. 18, no. 11, 2006, pp. 1143-50.
Senzolo M, Cholongitas E, Tibballs J, et al. Transjugular intrahepatic portosystemic shunt in the management of ascites and hepatorenal syndrome. Eur J Gastroenterol Hepatol. 2006;18(11):1143-50.
Senzolo, M., Cholongitas, E., Tibballs, J., Burroughs, A., & Patch, D. (2006). Transjugular intrahepatic portosystemic shunt in the management of ascites and hepatorenal syndrome. European Journal of Gastroenterology & Hepatology, 18(11), 1143-50.
Senzolo M, et al. Transjugular Intrahepatic Portosystemic Shunt in the Management of Ascites and Hepatorenal Syndrome. Eur J Gastroenterol Hepatol. 2006;18(11):1143-50. PubMed PMID: 17033432.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transjugular intrahepatic portosystemic shunt in the management of ascites and hepatorenal syndrome. AU - Senzolo,Marco, AU - Cholongitas,Evangelos, AU - Tibballs,Jonathan, AU - Burroughs,Andrew, AU - Patch,David, PY - 2006/10/13/pubmed PY - 2007/1/5/medline PY - 2006/10/13/entrez SP - 1143 EP - 50 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 18 IS - 11 N2 - Ascites is the most common complication of liver cirrhosis and when it develops mortality is 50% at 5 years, apart from liver transplantation. Large volume paracentesis has been the only option for ascites refractory to medical treatment. The role of transjugular intrahepatic portosystemic shunt in the management of diuretic-resistant ascites has been evaluated in many cohort studies and five randomized trials up to now, clearly showing improvement in natriuresis and clinical efficacy. It, however, remains unclear how transjugular intrahepatic portosystemic shunt affects survival and quality of life, because hospital admissions owing to worsening encephalopathy may counterbalance the reduced need of paracentesis. What is clear is that the patient selection is critical. About 30% of patients with ascites develop hepatorenal syndrome at 5 years, leading to high mortality in its severe and progressive form. As its main pathogenetic factor is derangement of circulatory function owing to portal hypertension, these patients may benefit from transjugular intrahepatic portosystemic shunt, but this has been shown only in small series, in which mortality remains very high, owing to the underlying poor liver function. SN - 0954-691X UR - https://www.unboundmedicine.com/medline/citation/17033432/Transjugular_intrahepatic_portosystemic_shunt_in_the_management_of_ascites_and_hepatorenal_syndrome_ L2 - https://doi.org/10.1097/01.meg.0000236872.85903.3f DB - PRIME DP - Unbound Medicine ER -