BACKGROUND: Transjugular intrahepatic portasystemic stent shunt (TIPSS), instead of surgical shunt, has become the standard treatment for @entity1 with complicated portal @entity101 . This study compared outcomes in @entity1 who underwent TIPSS or surgical shunting for complicated portal @entity101 . METHODS: This was a retrospective study of all consecutive @entity1 who received portasystemic shunts from 1994 to 2014 at a single institution. @entity1 who underwent surgical shunting were compared with those who had a TIPSS procedure following one-to-one propensity score matching. The primary study endpoints were overall survival and shunt failure, defined as major variceal rebleeding, relapse of @entity843 , irreversible @entity432 , @entity1578 requiring liver transplantation, or @entity204 . RESULTS: A total of 471 @entity1 received either a surgical shunt or TIPSS. Of these, 334 consecutive @entity1 with @entity82 who underwent elective surgical shunting (34) or TIPSS (300) for repeated @entity548 or @entity843 were evaluated. Propensity score matching yielded 31 pairs of @entity1 . There were no between-group differences in morbidity and 30-day mortality rates. However, shunt failure was less frequent after surgical shunting than TIPSS (6 of 31 versus 16 of 31; P   =   0  016). The 5-year shunt failure-free survival (77 versus 15 per cent; P   =   0  008) and overall survival (93 versus 42 per cent; P   =   0  037) rates were higher for @entity1 with surgical shunts. Multivariable analysis revealed that a @entity3851 ( @entity3851 ) score exceeding14 and TIPSS were independently associated with shunt failure. In @entity1 with @entity3851 scores of 14 or less, the 5-year overall survival rate remained higher after surgical shunting than TIPSS (100 versus 40 per cent; P   <   0  001). CONCLUSION: Surgical shunting achieved better results than TIPSS in @entity1 with complicated portal @entity101 and low @entity3851 scores.

Outcomes of surgical shunts and transjugular intrahepatic portasystemic stent shunts for complicated portal XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity82 :: ('MESH:D005355', 'Disease') :: ['cirrhosis'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension'] @entity548 :: ('MESH:D006470', 'Disease') :: ['variceal bleeding'] @entity843 :: ('MESH:D001201', 'Disease') :: ['refractory ascites'] @entity1578 :: ('MESH:D017093', 'Disease') :: ['liver failure'] @entity3851 :: ('MESH:D058625', 'Disease') :: ['MELD', 'Model for End-Stage Liver Disease'] @entity432 :: ('MESH:D001157', 'Disease') :: ['shunt occlusion'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity101 :: (MESH:D006973,Disease) :: ['hypertension']
