Prevention of post-tips hepatic encephalopathy: The search of the ideal candidate.

Abstract

Transjugular intrahepatic portosystemic shunt (TIPS) has been used since more than 25 years to treat some of the complications of portal hypertension, especially variceal bleeding and ascites refractory to conventional therapy. TIPS establishes a communication between the portal and hepatic veins, inducing the blood to shift from the splanchnic circulation into the systemic vascular bed with the aim of decompressing the portal venous system, and avoids the major complications of portal hypertension. However, the shunt of the portal blood into the systemic circulation is the cause of one of the major complications of the procedure: the post-TIPS hepatic encephalopathy (HE). To date, few pharmacological treatment has been proven effective to prevent this complication and thus, the identification of patients at high risk of post-TIPS hepatic encephalopathy and the patients' carefully selection is the only way to prevent this frequent complication.

• Authors: Silvia Nardelli, Daniele Bellafante, Lorenzo Ridola, Jessica Faccioli, Oliviero Riggio, Stefania Gioia
• Journal: Metabolic brain disease (Metab Brain Dis) Vol. 38 Issue 5 Pg. 1729-1736 (06 2023) ISSN: 1573-7365 [Electronic] United States
• PMID: 36445629 (Publication Type: Journal Article, Review)
• Copyright: © 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Topics

• Humans
• Hepatic Encephalopathy (complications)
• Esophageal and Gastric Varices (complications)
• Portasystemic Shunt, Transjugular Intrahepatic (adverse effects)
• Treatment Outcome
• Liver Cirrhosis (complications)
• Gastrointestinal Hemorrhage (etiology, prevention & control)
• Hypertension, Portal (complications)