Complications following transjugular intrahepatic portosystemic shunt: a retrospective analysis

Mortality and complications in patients with portal hypertension who underwent transjugular intrahepatic portosystemic shunt (TIPS) - 12 years experience

“…As previously demonstrated (26) , this study pointed encephalopathy as the main complication in 42 (58.3%) cases, higher indices than those reported in the literature which range from 10% to 44% (16) . Chronic encephalopathy was observed in 12 (16.7%) corroborating with literature with ratings from 5% to 20% (16) .…”

Albumin dialysis reduces portal pressure acutely in patients with severe alcoholic hepatitis

“…Indeed, in some patients acute TIPSS insertion for uncontrolled variceal bleeding results in death from cerebral herniation [28]. Thus the use of TIPSS in patients with liver failure and associated end-organ dysfunction is not without its difficulties even among those patients where successful control of bleeding is achieved with TIPSS [29][30][31][32]. In such a setting, the use of albumin dialysis would not only help treat the encephalopathy and/or liver failure, but as evident from these data, also lower portal pressure.…”

Errata

“…2 Hepatic encephalopathy is the most common complication following TIPS insertion. 3 However, it tends to present fairly early (within the first few months to a year). 1 First presentation of hepatic encephalopathy six years after the original TIPS insertion is extremely rare and we have not been able to find any reports describing such a late presentation as in our case.…”

“…Investigations looking for any obvious precipitating causes for hepatic encephalopathy were all negative as well. HIV control remained good with a CD4 count of 440 (cells/mm 3 ) and an undetectable viral load (he was then on lopinavir, ritonavir, abacavir and lamivudine).…”