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Digestive Disease Interventions 2018; 02(04): 395-401
DOI: 10.1055/s-0038-1675755
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Predictors and Management of Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt: The Current State of Literature

Connie Ju
1   School of Medicine, Case Western Reserve University, Cleveland, Ohio
2   Department of Radiology, Cleveland Clinic Foundation, Cleveland, Ohio
,
Brett E. Fortune
3   Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, New York
,
Karunakaravel Karuppasamy
2   Department of Radiology, Cleveland Clinic Foundation, Cleveland, Ohio
,
Baljendra Kapoor
2   Department of Radiology, Cleveland Clinic Foundation, Cleveland, Ohio
› Author Affiliations
Further Information

Publication History

06 September 2018

07 September 2018

Publication Date:
26 November 2018 (online)

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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
 

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