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  • Title: Surgery versus transjugular intrahepatic portal systemic shunt in the treatment of severe variceal bleeding.
    Author: Henderson JM.
    Journal: Clin Liver Dis; 2006 Aug; 10(3):599-612, ix. PubMed ID: 17162230.
    Abstract:
    The management of patients who have portal hypertension has changed dramatically over the last 2 decades. Pharmacologic therapy benefits the patient by reducing the risk for an initial bleed, improving the management of an acute bleed, and in reducing the risk for a rebleed. Endoscopic management has improved progressively along with endoscopic technology. For those 20% of patients that continues to have persistent high-risks varices or rebleed through first-line therapy, decompression does remain an option. The three options to decompression are liver transplant, a surgical shunt, or a transjugular intrahepatic portal systemic shunt (TIPS). This article focuses on the relative roles of these options with a particular emphasis on the current available data comparing surgical shunt with TIPS.
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