{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T16:37:30Z","timestamp":1765039050060,"version":"3.44.0"},"reference-count":38,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1996,9]]},"abstract":"<jats:p>BACKGROUND: Transjugular intrahepatic portosystemic stent shunts (TIPSS) are increasingly being used to manage the complications of portal hypertension. This study reports on the follow up on 130 patients who have undergone TIPSS. PATIENTS AND METHODS: One hundred and thirty patients (81 male), mean (SD) age 54.7 (12.5) years underwent TIPSS. The majority (64.6%) had alcoholic cirrhosis and 53.2% had Childs C disease. Indications were: variceal haemorrhage (76.2%), refractory ascites (13.1%), portal hypertensive gastropathy (4.6%), others (6.1%). Shunt function was assessed by Doppler ultrasonography and two then six monthly portography and mean follow up for survivors was 18.0 months (range 2-43.5). RESULTS: The procedure was successful in 119 (91.5%). Sixty three episodes of shunt dysfunction were observed in 45 (37.8%) patients. Variceal rebleeding occurred in 16 (13.4%) patients and was always associated with shunt dysfunction. Twenty (16.8%) patients had new or worse spontaneous encephalopathy after TIPSS and 11 (64.7%) patients had an improvement in resistant ascites. Thirty day mortality was 21.8% and one year survival 62.5%. CONCLUSION: TIPSS is an effective treatment for variceal bleeding, resistant ascites, and portal hypertensive gastropathy. Rebleeding is invariably associated with shunt dysfunction, the frequency of which increases with time, therefore regular and longterm shunt surveillance is required.<\/jats:p>","DOI":"10.1136\/gut.39.3.479","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"479-485","source":"Crossref","is-referenced-by-count":56,"title":["Longterm follow up of transjugular intrahepatic portosystemic stent shunt (TIPSS) for the treatment of portal hypertension: results in 130 patients."],"prefix":"10.1136","volume":"39","author":[{"given":"A J","family":"Stanley","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Jalan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E H","family":"Forrest","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D N","family":"Redhead","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P C","family":"Hayes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1996,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1007\/BF02575474","article-title":"The transjugular intrahepatic portosystemic stent-shunt (TIPSS): experience of results of a pilot study","volume":"13","author":"Richter, G.M.; Noeldge, G.; Palmaz, J.C.","year":"1990","unstructured":"Richter GM, Noeldge G, Palmaz JC. The transjugular intrahepatic portosystemic stent-shunt (TIPSS): experience of results of a pilot study. Cardiovasc Intervent Radiol 1990; 13: 200-7.","journal-title":"Cardiovasc Intervent Radiol"},{"key":"ref_2","first-page":"245","article-title":"Histoire naturelle des varices oesophagiennes au cours de la cirrhose (de la naissance a la rupture)","volume":"12","author":"Cales, P.; Pascal, J.P.","year":"1988","unstructured":"Cales P, Pascal JP, Histoire naturelle des varices oesophagiennes au cours de la cirrhose (de la naissance a la rupture). Gastroenterol Clin Biol 1988; 12: 245-54.","journal-title":"Gastroenterol Clin Biol"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/0016-5085(81)90144-X","article-title":"The course of patients after variceal haemorrhage","volume":"80","author":"Graham, D.; Smith, J.","year":"1981","unstructured":"Graham D, Smith J. The course of patients after variceal haemorrhage. 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Clin Gastroenterol 1985; 12: 233-57.","journal-title":"Clin Gastroenterol"},{"key":"ref_23","first-page":"281","article-title":"Non-shunting procedures in management of bleeding oesophageal varices","volume":"60","author":"WE, Jr, Matory; CE, Sedgwick; RL, Rossi","year":"1980","unstructured":"Matory WE Jr, Sedgwick CE, Rossi RL. Non-shunting procedures in management of bleeding oesophageal varices. SurgClinNorthAm 1980; 60: 281-95.","journal-title":"SurgClinNorthAm"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1056\/NEJM199401203300312","article-title":"The side-to-side shunt revisisted","volume":"330","author":"Grace, N.D.","year":"1994","unstructured":"Grace ND. The side-to-side shunt revisisted. N Engl Jt Med 1994; 330: 208-9.","journal-title":"N Engl Jt Med"},{"key":"ref_25","first-page":"147","article-title":"Wallstents or Palmaz stents for the tranajugular intrahepatic portosystemic stent-shunt (TIPSS)","volume":"9","author":"Jalan, R.; Redhead, D.N.; Ferguson, J.; Simpson, K.J.; Elton, R.A.; Hayes, P.C.","year":"1994","unstructured":"Jalan R, Redhead DN, Ferguson J, Simpson KJ, Elton RA, Hayes PC. Wallstents or Palmaz stents for the tranajugular intrahepatic portosystemic stent-shunt (TIPSS). Jf Interoent Radiol 1994; 9: 147-52.","journal-title":"Jf Interoent Radiol"},{"key":"ref_26","first-page":"20","article-title":"The role of duplex and colour flow doppler utrasonography in the assessment of TIPSS shunt function","author":"Jalan, R.; Ferguson, J.; Allan, P.L.; Redhead, D.N.; Hayes, P.C.","unstructured":"Jalan R, Ferguson J, Allan PL, Redhead DN, Hayes PC. The role of duplex and colour flow doppler utrasonography in the assessment of TIPSS shunt function. 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Transjugular intrahepatic portocaval stent shunts in patients with renal insufficiency. TransplantProc 1993; 25: 1766-7.","journal-title":"TransplantProc"},{"issue":"1 13","key":"ref_33","article-title":"Effect of TIPSS on splanchnic and renal production of endothelins","volume":"20","author":"Martinet, J.P.; Legault, L.; Cernacek, P.","year":"1994","unstructured":"Martinet JP, Legault L, Cernacek P, et al. Effect of TIPSS on splanchnic and renal production of endothelins. Hepatology 1994; 20: 1 13A.","journal-title":"Hepatology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/0270-9139(93)92665-M","article-title":"Liver function and blood flow before and after TIPSS","volume":"18","author":"Rossle, M.; Sellinger, M.; Ochs, A.; Haag, K.","year":"1993","unstructured":"Rossle M, Sellinger M, Ochs A, Haag K. Liver function and blood flow before and after TIPSS. 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World Jf Surg 1984; 8: 722-32.","journal-title":"World Jf Surg"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/0168-8278(95)80325-4","article-title":"Analysis of prognostic variables in the prediction of mortality, shunt failure, variceal rebleeding and encephalopathy following the transjugular intrahepatic portosystemic stent-shunt for variceal haemorrhage","volume":"23","author":"Jalan, R.; Elton, R.; Redhead, D.N.; Finlayson, N.D.C.; Hayes, P.C.","year":"1995","unstructured":"Jalan R, Elton R, Redhead DN, Finlayson NDC, Hayes PC. Analysis of prognostic variables in the prediction of mortality, shunt failure, variceal rebleeding and encephalopathy following the transjugular intrahepatic portosystemic stent-shunt for variceal haemorrhage. J Hepatol 1995; 23: 123-8.","journal-title":"J Hepatol"},{"issue":"5","key":"ref_38","first-page":"24","article-title":"Transjugular intrahepatic portosystemic stent-shunt (TIPSS) insertion as a preclude to orthotopic liver transplantation (OLT) in patients with severe portal hypertension","volume":"35","author":"John, T.G.; Jalan, R.; Redhead, D.N.; Hayes, P.C.; Sanfey, H.A.; Garden, O.J.","year":"1994","unstructured":"John TG, Jalan R, Redhead DN, Hayes PC, Sanfey HA, Garden OJ. Transjugular intrahepatic portosystemic stent-shunt (TIPSS) insertion as a preclude to orthotopic liver transplantation (OLT) in patients with severe portal hypertension. 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