Clinical application of early transjugular intrahepatic portosystemic shunt and related and research advances
10.3969/j.issn.1001-5256.2023.07.001
- VernacularTitle:早期经颈静脉肝内门体分流术临床应用及研究进展
- Author:
Ze WANG
1
;
Jintao HUANG
1
;
Binyan ZHONG
1
;
Jian SHEN
1
;
Xiaoli ZHU
1
Author Information
1. Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China
- Publication Type:Editorial
- Keywords:
Portasystemic Shunt, Transjugular Intrahepatic;
Esophageal and Gastric Varices;
Hemorrhage
- From:
Journal of Clinical Hepatology
2023;39(7):1513-1522
- CountryChina
- Language:Chinese
-
Abstract:
Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure to establish a portosystemic shunt between the hepatic vein and the portal vein via the jugular approach, so as to reduce portal venous pressure and control acute esophagogastric variceal bleeding (EGVB). The prognosis of EGVB has been improved significantly over the past few decades, and endoscopic variceal ligation combined with drug therapy is now recommended as the first-line treatment regimen for this disease. The latest research advances in the management of EGVB over the past decade have focused on the relatively new concept of "early" or "pre-emptive" TIPS, that is to say, early TIPS (within 72 hours after admission, ideally within 24 hours) is recommended for patients with EGVB who are at a relatively high risk of failure in standard treatment. This article briefly introduces the effect of early TIPS on controlling bleeding, mortality rate, and hepatic encephalopathy, the high-risk population for early TIPS, timing of intervention, cost effectiveness, the applications of early TIPS in a real-world setting, and recommendations for early TIPS in international guidelines and consensus statements.
