{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T21:10:51Z","timestamp":1761340251088,"version":"3.41.2"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T00:00:00Z","timestamp":1718841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Colorectal surgery in patients with inflammatory bowel disease (IBD) and cirrhosis has increased morbidity, which may preclude surgery. Preoperative transjugular intrahepatic portosystemic shunt (TIPS) is postulated to reduce surgical risk. In this retrospective single-center study, we characterized perioperative outcomes in patients with IBD and cirrhosis who underwent preoperative TIPS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We identified patients with IBD and cirrhosis who had undergone preoperative TIPS for portal decompression between 2010 and 2023. All other indications for TIPS led to patient exclusion. Demographic and medical data were collected, including portal pressure measurements. Primary outcome of interest was perioperative outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Ten patients met the inclusion criteria. The most common surgical indications were dysplasia (50%) and refractory IBD (50%). TIPS was performed at a median of 47 days (IQR 34\u201380) before surgery, with reduction in portal pressures (22.5 vs. 18.5 mmHg, P\u2005&amp;lt;\u2005.01) and portosystemic gradient (12.5 vs. 5.5 mmHg, P\u2005&amp;lt;\u2005.01). Perioperative complications occurred in 80% of patients, including surgical site bleeding (30%), wound dehiscence (10%), systemic infection (30%), liver function elevation (50%), and coagulopathy (50%). No patients required re-operation, with median length of stay being 7 days (IQR 5.5\u20139.3). The 30-day readmission rate was 40%, most commonly for infection (75%), with 2 patients having intra-abdominal abscesses and 1 patient with concern for bowel ischemia. Ninety-day and one-year survival was 100% and 90%, respectively. Patients with primary sclerosing cholangitis (PSC)-cirrhosis were noted to have higher perioperative morbidity and a 30-day readmission rate.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In patients with IBD and cirrhosis, preoperative TIPS facilitated successful surgical intervention despite heightened risk. Nevertheless, significant complications were noted, in particular for patients with PSC-cirrhosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/crocol\/otae037","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T21:39:11Z","timestamp":1718833151000},"source":"Crossref","is-referenced-by-count":1,"title":["Successful Preoperative Transjugular Intrahepatic Portosystemic Shunt for Portal Decompression in Patients With Inflammatory Bowel Disease and Cirrhosis Requiring Surgical Intervention"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0383-613X","authenticated-orcid":false,"given":"Christian","family":"Karime","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Mayo Clinic , Jacksonville, FL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asrita","family":"Vattikonda","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Mayo Clinic , Jacksonville, FL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jana G","family":"Hashash","sequence":"additional","affiliation":[{"name":"Inflammatory Bowel Disease Centre, Department of Gastroenterology and Hepatology, Mayo Clinic , Jacksonville, FL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barry G","family":"Rosser","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Mayo Clinic , Jacksonville, FL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Merchea","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Mayo Clinic , Jacksonville, FL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Stocchi","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Mayo Clinic , Jacksonville, FL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis A","family":"Farraye","sequence":"additional","affiliation":[{"name":"Inflammatory Bowel Disease Centre, Department of Gastroenterology and Hepatology, Mayo Clinic , Jacksonville, FL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,6,20]]},"reference":[{"issue":"9","key":"2024070313393620300_CIT0001","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1097\/MIB.0000000000000065","article-title":"Hepatobiliary manifestations of inflammatory bowel disease","volume":"20","author":"Yarur","year":"2014","journal-title":"Inflamm Bowel Dis."},{"issue":"12","key":"2024070313393620300_CIT0002","doi-asserted-by":"crossref","first-page":"1956","DOI":"10.4254\/wjh.v13.i12.1956","article-title":"Liver manifestations and complications in inflammatory bowel disease: a review","volume":"13","author":"Gaspar","year":"2021","journal-title":"World J Hepatol."},{"issue":"8","key":"2024070313393620300_CIT0003","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1007\/DCR.0b013e3181a80dca","article-title":"The impact of cirrhosis and portal hypertension on mortality following colorectal surgery: a nationwide, population-based study","volume":"52","author":"Nguyen","year":"2009","journal-title":"Dis Colon Rectum."},{"issue":"4","key":"2024070313393620300_CIT0004","doi-asserted-by":"crossref","first-page":"1594","DOI":"10.1007\/s00464-009-0405-7","article-title":"Preoperative transjugular intrahepatic portosystemic shunt (TIPS) for cirrhotic patients undergoing abdominal and pelvic surgeries","volume":"23","author":"Schlenker","year":"2009","journal-title":"Surg Endosc."},{"issue":"1","key":"2024070313393620300_CIT0005","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.ejso.2003.10.014","article-title":"The role of transjugular intrahepatic portosystemic shunt prior to abdominal tumoral surgery in cirrhotic patients with portal hypertension","volume":"30","author":"Gil","year":"2004","journal-title":"Eur J Surg Oncol."},{"issue":"1","key":"2024070313393620300_CIT0006","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/S1072-7515(01)00911-5","article-title":"Neoadjuvant transjugular intrahepatic portosystemic shunt: a solution for extrahepatic abdominal operation in cirrhotic patients with severe portal hypertension","volume":"193","author":"Azoulay","year":"2001","journal-title":"J Am Coll Surg."},{"issue":"3","key":"2024070313393620300_CIT0007","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1093\/gastro\/gou085","article-title":"Impact of transjugular intrahepatic portosystemic shunt on post-colectomy complications in patients with ulcerative colitis and primary sclerosing cholangitis","volume":"3","author":"Kochhar","year":"2015","journal-title":"Gastroenterol Rep (Oxf)."},{"issue":"1","key":"2024070313393620300_CIT0008","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1097\/DCR.0b013e3182315745","article-title":"Inflammatory bowel disease complicated by primary sclerosing cholangitis and cirrhosis: is restorative proctocolectomy safe","volume":"55","author":"Lian","year":"2012","journal-title":"Dis Colon Rectum."},{"issue":"8","key":"2024070313393620300_CIT0009","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1007\/s10350-008-9336-y","article-title":"Colorectal surgery in cirrhotic patients: assessment of operative morbidity and mortality","volume":"51","author":"Meunier","year":"2008","journal-title":"Dis Colon Rectum."},{"issue":"4","key":"2024070313393620300_CIT0010","doi-asserted-by":"crossref","first-page":"364","DOI":"10.5152\/dir.2014.13479","article-title":"How quickly does ascites respond to TIPS? Clinical follow-up of a cohort of eighty patients","volume":"20","author":"Gaba","year":"2014","journal-title":"Diagn Interv Radiol."}],"container-title":["Crohn's &amp; Colitis 360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/advance-article-pdf\/doi\/10.1093\/crocol\/otae037\/58283097\/otae037.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/article-pdf\/6\/3\/otae037\/58412382\/otae037.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/article-pdf\/6\/3\/otae037\/58412382\/otae037.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T13:39:55Z","timestamp":1720013995000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/crohnscolitis360\/article\/doi\/10.1093\/crocol\/otae037\/7696412"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,20]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/crocol\/otae037","relation":{},"ISSN":["2631-827X"],"issn-type":[{"type":"electronic","value":"2631-827X"}],"subject":[],"published-other":{"date-parts":[[2024,7]]},"published":{"date-parts":[[2024,6,20]]},"article-number":"otae037"}}