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Digestive Diseases and Sciences
Erschienen in: Digestive Diseases and Sciences 2/2017

05.01.2017 | Review

An Algorithm for Management After Transjugular Intrahepatic Portosystemic Shunt Placement According to Clinical Manifestations

verfasst von: Seung Kwon Kim, Bryan G. Belikoff, Carlos J. Guevara, Seong Jin Park

Erschienen in: Digestive Diseases and Sciences | Ausgabe 2/2017

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Abstract

We propose an algorithm for management after transjugular intrahepatic portosystemic shunt (TIPS) placement according to clinical manifestations. For patients with an initial good clinical response, surveillance Doppler ultrasound is recommended to detect stenosis or occlusion. A TIPS revision can be performed using basic or advanced techniques to treat stenosis or occlusion. In patients with an initial poor clinical response, a TIPS venogram with pressure measurements should be performed to assess shunt patency. The creation of a parallel TIPS may also be required if the patient is symptomatic and the portal pressure remains high after TIPS revision. Additional procedures may also be necessary, such as peritoneovenous shunt (Denver shunt) placement for refractory ascites, tunneled pleural catheter for hepatic hydrothorax, and balloon-occluded retrograde transvenous obliteration procedure for gastric variceal bleeding. A TIPS reduction procedure can also be performed in patients with uncontrolled hepatic encephalopathy or hepatic failure.
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Metadaten
Titel
An Algorithm for Management After Transjugular Intrahepatic Portosystemic Shunt Placement According to Clinical Manifestations
verfasst von
Seung Kwon Kim
Bryan G. Belikoff
Carlos J. Guevara
Seong Jin Park
Publikationsdatum
05.01.2017
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 2/2017
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-016-4399-4

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