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Transjugular intrahepatic portosystemic shunt: an analysis of outcomes.
ANZ J Surg. 2009 Oct; 79(10):745-9.AJ

Abstract

BACKGROUND

Transjugular intrahepatic portosystemic shunts (TIPS) are utilized for the management of complications of portal hypertension, particularly diuretic-resistant ascites and recurrent variceal bleeding. It has also been applied in Budd-Chiari syndrome and hepatorenal syndrome. We report the results in a small series, over 9 years, from a single centre, and compare these to those published in the literature.

METHODS

A retrospective case note review of 20 consecutive TIPS procedures performed at Flinders Medical Centre from January 1997 to December 2005 was completed. All indications were included in the analysis. Underlying liver disease, peri-procedure complications, relief of symptoms and patient survival were recorded. Data on type of TIPS, shunt patency and method of follow-up were recorded.

RESULTS

Thirty-six TIPS were performed in 20 subjects. All initial TIPS attempts were successful. Indications were: refractory ascites (18), acute variceal bleeding (12) and hepatorenal syndrome (2). There were no peri-procedure deaths, however. Ninety-day mortality was 20%. Outcomes in model of end-stage liver disease score and biochemical characteristics post-TIPS were comparable to those reported. Overall, TIPS dysfunction rate was 35% at 1 year. TIPS follow-up and patency surveillance was an ad hoc combination of Doppler ultrasound and venography.

CONCLUSION

TIPS procedure outcomes in our centre are similar to those reported in the literature from large centres. TIPS patency rates may be improved with regular monitoring and early intervention when stenosis occurs.

Authors+Show Affiliations

Division of Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia. tim.kurmis@health.sa.gov.au

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19878172

Citation

Kurmis, Timothy P.. "Transjugular Intrahepatic Portosystemic Shunt: an Analysis of Outcomes." ANZ Journal of Surgery, vol. 79, no. 10, 2009, pp. 745-9.
Kurmis TP. Transjugular intrahepatic portosystemic shunt: an analysis of outcomes. ANZ J Surg. 2009;79(10):745-9.
Kurmis, T. P. (2009). Transjugular intrahepatic portosystemic shunt: an analysis of outcomes. ANZ Journal of Surgery, 79(10), 745-9. https://doi.org/10.1111/j.1445-2197.2009.05093.x
Kurmis TP. Transjugular Intrahepatic Portosystemic Shunt: an Analysis of Outcomes. ANZ J Surg. 2009;79(10):745-9. PubMed PMID: 19878172.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transjugular intrahepatic portosystemic shunt: an analysis of outcomes. A1 - Kurmis,Timothy P, PY - 2009/11/3/entrez PY - 2009/11/3/pubmed PY - 2010/1/20/medline SP - 745 EP - 9 JF - ANZ journal of surgery JO - ANZ J Surg VL - 79 IS - 10 N2 - BACKGROUND: Transjugular intrahepatic portosystemic shunts (TIPS) are utilized for the management of complications of portal hypertension, particularly diuretic-resistant ascites and recurrent variceal bleeding. It has also been applied in Budd-Chiari syndrome and hepatorenal syndrome. We report the results in a small series, over 9 years, from a single centre, and compare these to those published in the literature. METHODS: A retrospective case note review of 20 consecutive TIPS procedures performed at Flinders Medical Centre from January 1997 to December 2005 was completed. All indications were included in the analysis. Underlying liver disease, peri-procedure complications, relief of symptoms and patient survival were recorded. Data on type of TIPS, shunt patency and method of follow-up were recorded. RESULTS: Thirty-six TIPS were performed in 20 subjects. All initial TIPS attempts were successful. Indications were: refractory ascites (18), acute variceal bleeding (12) and hepatorenal syndrome (2). There were no peri-procedure deaths, however. Ninety-day mortality was 20%. Outcomes in model of end-stage liver disease score and biochemical characteristics post-TIPS were comparable to those reported. Overall, TIPS dysfunction rate was 35% at 1 year. TIPS follow-up and patency surveillance was an ad hoc combination of Doppler ultrasound and venography. CONCLUSION: TIPS procedure outcomes in our centre are similar to those reported in the literature from large centres. TIPS patency rates may be improved with regular monitoring and early intervention when stenosis occurs. SN - 1445-2197 UR - https://www.unboundmedicine.com/medline/citation/19878172/Transjugular_intrahepatic_portosystemic_shunt:_an_analysis_of_outcomes_ L2 - https://doi.org/10.1111/j.1445-2197.2009.05093.x DB - PRIME DP - Unbound Medicine ER -