Indications n Contraindiations of TIPS

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Indications


Accepted indications
Control of refractory acute variceal bleeding
Prevention of refractory recurrent variceal bleeding in Child class B and C patients
Refractory hepatic hydrothorax
Budd-Chiari syndrome
Refractory ascites

Promising but unproven
Hepatorenal syndrome
Veno-occlusive disease


Unproven
Prevention of refractory variceal bleeding in Child class A patients
Initial therapy of acute variceal hemorrhage
Initial therapy to prevent recurrent variceal hemorrhage
Prevention of initial variceal hemorrhage
Reduction in intraoperative morbidity rate during liver transplantation
Hepatopulmonary syndrome





Contraindications


Absolute contraindications
Right-sided heart failure
Primary pulmonary hypertension
Polycystic liver disease
Severe hepatic failure
Portal vein thrombosis with cavernous transformation


Relative contraindications
Biliary obstruction
Active intrahepatic or systemic infection
Severe hepatic encephalopathy poorly controlled by medical therapy
Portal vein thrombosis without cavernous transformation

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