Abstract
Hepatic encephalopathy is a well-known sequela of transjugular intrahepatic portosystemic
shunt (TIPS) insertion, but objective clinical and laboratory predictors remain poorly
elucidated. Numerous medical and interventional strategies have also been described,
though little consensus has been reached on the optimal treatment technique to improve
morbidity and mortality in patients who develop refractory encephalopathy. To improve
TIPS candidate selection and prognostication, this review consolidates predictive
factors for post-TIPS encephalopathy and offers an updated description of historical
and contemporary interventional techniques for management. Despite the abundant literature
on treatment strategies, large studies directly comparing outcomes between the various
techniques are nonexistent.
Keywords
hepatic encephalopathy - TIPS - predictors - management
