Management of hepatic encephalopathy following transjugular intrahepatic portosystemic shunts:Current strategies and future directions  

作　　者：Ying Li Yu-Tong Wu Hao Wu 

机构地区：[1]Department of Gastroenterology and Hepatology,West China Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China [2]Chongqing Medical University-University of Leicester Joint Institute,Chongqing Medical University,Chongqing 400016,China

出　　处：《World Journal of Gastroenterology》2025年第15期8-23,共16页世界胃肠病学杂志(英文)

基　　金：Supported by the National Natural Science Foundation of China,No.82270649.

摘　　要：Transjugular intrahepatic portosystemic shunts(TIPSs)are generally used for the management of complications of portal hypertension in patients with decompensated cirrhosis.However,hepatic encephalopathy(HE),which impairs neuropsychiatric function and motor control,remains the primary adverse effect of TIPS,limiting its utility.Prompt prevention and treatment of post-TIPS HE are critical,as they are strongly associated with readmission rates and poor quality of life.This review focuses on the main pathophysiological mechanisms underlying post-TIPS HE,explores advanced biomarkers and predictive tools,and discusses current management strategies and future directions to prevent or reverse HE following TIPS.These strategies include preoperative patient assessment,individualized shunt diameter optimization,spontaneous portosystemic shunt embolization during the TIPS procedure,postoperative preventive and therapeutic measures such as nutrition management,medical therapy,fecal microbiota transplantation,and stent reduction.

关 键 词：CIRRHOSIS Portal hypertension Transjugular intrahepatic portosystemic shunt Hepatic encephalopathy Pathophysiological mechanisms Management strategies 

分 类 号：R575.2[医药卫生—消化系统]