TIPS FOR REFRACTORY ASCITES - NEITHER HEMLOCK NOR PANACEA - THE MONTREAL EXPERIENCE AND REVIEW OF THE LITERATURE

Refractory ascites worsens the end-stage course of decompensated cirrh osis. Transjugular intrahepatic portasystemic shunt (TIPS) has been pr oposed to treat this condition with erratic success, inducing controve rsial reports on the risk-benefit ratio associated to this technique. In order to assess the usefulness of TIPS for this indication, this pa per updates some definitions concerning the refractory ascites, We als o analyze the main complications of TIPS and review some physiopatholo gical pathways, taking peculiar interest in the Montreal experience.