Pre-emptive TIPSS in Acute Variceal Bleeding:Current Status,Controversies,and Future Directions  

作　　者：Yu Jun Wong Wei Ling Danielle Ho Juan G.Abraldes 

机构地区：[1]Department of Gastroenterology and Hepatology,Changi General Hospital,Singapore [2]Duke-NUS Medical School,Singa-pore [3]Division of Gastroenterology,University of Alberta,Edmonton,Canada

出　　处：《Journal of Clinical and Translational Hepatology》2022年第6期1223-1228,共6页临床与转化肝病杂志（英文版）

摘　　要：Acute variceal bleeding(AVB)is associated with signifi-cant short-term morbidity and mortality.Pre-emptive tran-sjugular intrahepatic portosystemic shunt(p-TIPSS)is recommended to prevent rebleeding in AVB patients with a high risk of rebleeding.Despite the benefit of prevent-ing rebleeding and de-novo ascites,the uptake of p-TIPSS remains low because logistic challenges in the real-world setting.In this review,we summarize the current evidence and controversies on p-TIPSS including patient selection for p-TIPSS,particularly in the setting of NASH cirrhosis and acute-on-chronic liver failure,the role of sarcopenia,renal impairment in the setting of p-TIPSS.Finally,we summarize both pharmacological and nonpharmacological strategies to optimize outcomes in patients undergoing p-TIPSS.

关 键 词：Transjugular intrahepatic portosystemic shunt HEMORRHAGE Portal hypertension CIRRHOSIS 

分 类 号：R575.2[医药卫生—消化系统]