TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNTS FOR PORTAL-HYPERTENSION

Transjugular intrahepatic portosystemic shunt (TIPS) has rapidly becom e a widely disseminated procedure. It is both feasible and safe. TIPS has proved effective for treatment of acute variceal bleeding and is p robably an effective therapy for intractable ascites. Nonetheless, it is important to define the appropriate subpopulation best suited for T IPS. Given the poor long-term patency of TIPS and the need for close f ollow-up, TIPS is not optimal therapy for an unreliable patient who is not a candidate for liver transplantation. TIPS is especially useful in the patient anticipating liver transplantation soon after TIPS. Fur ther study is needed to define the optimal use for TIPS.