Transjugular intrahepatic porto-systemic shunt in bleeding esophageal varices and refractory ascites. The first 4 years experience in Assiut University Hospital

Aim: To evaluate our first four years experience with 71 cases of TIPSS procedures performed in Assiut University Hospital. Patients and methods: Between February 2011 and April 2015, seventy-one patients who underwent TIPSS procedure in Assiut University Hospital were included in this study. The patients were selected among those suffering from refractory hepatic ascites and/or recurrent hematemesis due to variceal bleeding. Follow-up duration of our patients ranged from 3 to 34 months (mean 15.8). Results: The mean age of the patients was 47 ± 10.7 years. The technical success rate was 83%. Seventy-five percent of patients with refractory ascites improved after TIPSS. Reduction of variceal size occurred in 84.6% of patients. The 3 months mortality rate was 8%. Conclusion: Proper pre-procedural investigations and patients selection are mandatory for practicing TIPSS. BCS is a common cause of technical and clinical failure of TIPSS, so practicing TIPSS in BCS should be reserved for experts.