Transjugular intrahepatic portosystemic shunt and non-selective beta-blockers act as friends or foe in decompensated cirrhosis: A comparative review  

作　　者：Eyad Gadour Syed A Gardezi 

机构地区：[1]Multi-organ Transplant Centre of Excellence,Liver Transplantation Unit,King Fahad Specialist Hospital,Dammam 32253,Saudi Arabia [2]Internal Medicine,Zamzam University College,School of Medicine,Khartoum 11113,Sudan [3]Department of Gastroenterology,John Hopkins Aramco Healthcare,Dhahran 34465,Saudi Arabia

出　　处：《World Journal of Gastrointestinal Surgery》2025年第4期12-21,共10页世界胃肠外科杂志(英文)

摘　　要：The management of portal hypertension and its complications,such as variceal bleeding,in patients with cirrhosis often involves the use of nonselective betablockers(NSBBs)and a transjugular intrahepatic portosystemic shunt(TIPS).Both treatment modalities have demonstrated efficacy;however,each presents distinct challenges and benefits.NSBBs,including propranolol,nadolol,and carvedilol,effectively reduce portal pressure,but are associated with side effects such as bradycardia,hypotension,fatigue,and respiratory issues.Additionally,NSBBs can exacerbate conditions such as refractory ascites,hepatorenal syndrome,and hepatic encephalopathy.In contrast,TIPS effectively reduces the incidence of variceal rebleeding,controlling refractory ascites.However,it is associated with a significant risk of hepatic encephalopathy,shunt dysfunction,and procedurerelated complications including bleeding and infection.The high cost of TIPS,along with the need for regular follow-up and potential re-intervention,poses additional challenges.Furthermore,patient selection for TIPS is critical,as inappropriate candidates may experience suboptimal outcomes.Future studies comparing NSBBs and TIPS should focus on refining the patient selection criteria,enhancing procedural techniques,optimising combination therapies,and conducting long-term outcome studies.Personalised treatment approaches,costeffectiveness analyses,and improved patient education and support are essential for maximising the use of these therapies.

关 键 词：Transjugular intrahepatic portosystemic shunt Liver cirrhosis Variceal bleeding Nonselective beta-blockers Portal hypertension 

分 类 号：R57[医药卫生—消化系统]