CLINICAL EFFICACY AND COMPLICATIONS OF TR ANS-JUGULAR INTRAHEPATIC PORTOSYSTEMIC STENT-SHUNT

TIPSS is a new therapeutic modality for decompressing the portal tree and its use has broadened in the last five years. From February 1993 t o August 1994 a prospective study was performed to evaluate its effica cy and safety. Nineteen cirrhotic patients (Child A-5, B-10, and C-4) with a TIPSS placed were included. The mean follow-up was 7.2 months. The indication was therapy of esophageal variceal bleeding in 18 patie nts (acutely in 8 and elective in 10 patients) and refractory ascites in one. in all cases could the ''stent'' be placed and the portocaval gradient decreased from 22.8 +/- 3.71 to 9.3 +/- 2.27 mmHg, In the fir st thrirty days the mortality rate was 10.5%, with the following compl ications: two portal thromboses, two acute non-lithiasic cholecystitis , one hemoperitoneum, one spontaneus bacterial peritonitis, and one he patic encephalopathy. During the follow-up period two patients develop ed hemorrhagic relapses and two additional patients subclinic encephal opathy. TIPSS dysfunction was observed in 57.8%.