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TIPS for refractory ascites: a single-centre experience

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Purpose

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.

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Authors and Affiliations

  1. The Sheila Sherlock Hepatobiliarypancreatic and Liver Transplantation Unit, Royal Free Hospital, Pond Street, London, NW3 2QG, UK

    Ulrich Thalheimer, Gioacchino Leandro, Dimitrios N. Samonakis, Christos K. Triantos, Marco Senzolo, Konrad Fung, David Patch & Andrew K. Burroughs

  2. Department of Radiology, Royal Free Hospital, Pond Street, London, NW3 2QG, UK

    Neil Davies

Authors
  1. Ulrich Thalheimer
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  2. Gioacchino Leandro
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  3. Dimitrios N. Samonakis
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  4. Christos K. Triantos
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  5. Marco Senzolo
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  6. Konrad Fung
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  7. Neil Davies
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  8. David Patch
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  9. Andrew K. Burroughs
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Corresponding author

Correspondence to Andrew K. Burroughs.

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Thalheimer, U., Leandro, G., Samonakis, D.N. et al. TIPS for refractory ascites: a single-centre experience. J Gastroenterol 44, 1089–1095 (2009). https://doi.org/10.1007/s00535-009-0099-6

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  • DOI: https://doi.org/10.1007/s00535-009-0099-6

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