The use of shunts for the treatment of portal @entity101 has been revived after the introduction of the transjugular intrahepatic portosystemic shunt (TIPS) into clinical practice. This interventional procedure has mainly been used as rescue treatment for @entity548 resistant to endoscopic therapy and for @entity843 refractory to diuretic treatment and paracentesis. With respect to @entity548 TIPS has a low rate of "operative" mortality of < 1% and variceal rebleeding of 6 to 18%. In @entity1 with refractory @entity843 the response to treatment is 50 to 92%. The major problems of the TIPS procedure are the increased incidence of @entity99 and the high rate of shunt insufficiency of about 50%. Therefore, control of shunt function by duplex-sonography is essential to detect malfunction of the shunt. Radiological revision is then indicated if the clinical symptoms of portal @entity101 (varices, @entity843 ) reappear. The TIPS treatment has partially replaced the surgical shunting procedures. This decision is based on the potentially higher mortality of the surgical procedure. However, this has not been proven by randomized studies and, therefore, surgical shunts may also be indicated in selected @entity1 with low operative mortality.

[Treatment of portal XXXX by portosystemic shunts].

@entity1 :: ('9606', 'Species') :: ['patients'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension'] @entity548 :: ('MESH:D006470', 'Disease') :: ['variceal bleeding'] @entity843 :: ('MESH:D001201', 'Disease') :: ['ascites'] @entity99 :: ('MESH:D056486', 'Disease') :: ['hepatic encephalopathy']
@entity101 :: (MESH:D006973,Disease) :: ['hypertension']
