{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:19:26Z","timestamp":1792210766319,"version":"4.4.0"},"reference-count":74,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T00:00:00Z","timestamp":1645142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In light of the global rise in the burden of chronic liver diseases and liver cirrhosis, the number of patients suffering from decompensation events is expected to increase. Transjugular intrahepatic portosystemic shunts (TIPSS) provide effective long\u2010term symptom control and may prolong transplant\u2010free survival in portal hypertension\u2010driven recurrent ascites and variceal bleeding. New\u2010onset or recurrent hepatic encephalopathy (HE) after TIPSS insertion (post\u2010TIPSS HE) represents the most severe post\u2010interventional complication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To provide insight into the epidemiology and risk factors for post\u2010TIPSS HE and scrutinize the current state of the art in treatment and drug therapy options.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a literature search on post\u2010TIPSS HE in patients with liver cirrhosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Post\u2010TIPSS HE occurs in up to 54.5% of cases and particularly early recurrent HE is associated with a dismal prognosis. In recent years, several risk factors for the development of post\u2010TIPSS HE have been identified. These include not only parameters reflecting liver function (model for end\u2010stage liver disease score\/Child\u2010Pugh score) as well as cognitive dysfunction caused by minimal HE but also extrahepatic factors such as sarcopenia and common medications such as proton pump inhibitors. In addition, new data on the benefit of rifaximin and of smaller stent grafts emerged and may improve the prevention of post\u2010TIPSS HE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Careful selection of TIPSS candidates is of utmost importance to reduce the risk of post\u2010TIPSS HE. In this narrative review, we provide a concise overview of the current epidemiology and risk factors of the treatment options for post\u2010TIPSS HE.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16825","type":"journal-article","created":{"date-parts":[[2022,2,19]],"date-time":"2022-02-19T07:19:45Z","timestamp":1645255185000},"page":"1265-1276","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Review article: post\u2010<scp>TIPSS<\/scp> hepatic encephalopathy\u2014current knowledge and future perspectives"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3240-5152","authenticated-orcid":false,"given":"Simon Johannes","family":"Gairing","sequence":"first","affiliation":[{"name":"Department of Internal Medicine I University Medical Center of the Johannes Gutenberg\u2010University  Mainz Germany"},{"name":"Cirrhosis Center Mainz (CCM) University Medical Center of the Johannes 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