Transjugular intrahepatic portosystemic shunt before abdominal surgery in cirrhotic patients

“Abdominal surgery is occasionally needed in cirrhotic patients and is associated with high morbidity and mortality rates. It has been suggested that the main determinant of short- and long-term survival is the degree of liver failure, as evaluated by the presence of ascites, low serum albumin level and coagulation disorders. In addition, the degree of portal
hypertension may be an independent predictor for operative bleeding, postoperative ascites leakage or variceal rupture; this may also influence survival. Transjugular intrahepatic portosystemic shunt (TIPS) placement is much less invasive than surgical shunts and can be performed in patients with a significant degree of liver insufficiency. Therefore, it has been suggested that preoperative TIPS placement may improve the prognosis of cirrhotic patients, submitted to abdominal surgery.”

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Portal hypertensive bleeding: The place of portosystemic shunting

Knechtle SJ, Galloway JR. (2017) Chapter 85. Portal hypertensive bleeding: The place of portosystemic shunting. Ed.: Jarnagin WR, In Blumgart’s Surgery of the Liver, Biliary Tract and Pancreas, 2-Volume Set (6th ed.), Elsevier, pgs. 1218-1230.e3.

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