Transjugular intrahepatic portosystemic stent shunt for medically refractory hepatic hydrothorax: A systematic review and cumulative meta-analysis

Ivo C. Ditah, Badr F. Al Bawardy, Behnam Saberi, Chobufo Ditah, Patrick Sequeira Kamath

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

AIM: To assess the effectiveness of transjugular intrahepatic portosystemic stent shunt (TIPSS) in refractory hepatic hydrothorax (RHH) in a systematic review and cumulative meta-analysis. METHODS: A comprehensive literature search was conducted on MEDLINE, EMBASE, and PubMed covering the period from January 1970 to August 2014. Two authors independently selected and abstracted data from eligible studies. Data were summarized using a random-effects model. Heterogeneity was assessed using the I<sup>2</sup> test. RESULTS: Six studies involving a total of 198 patients were included in the analysis. The mean (SD) age of patients was 56 (1.8) years. Most patients (56.9%) had Child-Turcott-Pugh class C disease. The mean duration of follow-up was 10 mo (range, 5.7-16 mo). Response to TIPSS was complete in 55.8% (95%CI: 44.7%-66.9%), partial in 17.6% (95%CI: 10.9%-24.2%), and absent in 21.2% (95%CI: 14.2%-28.3%). The mean change in hepatic venous pressure gradient post-TIPSS was 12.7 mmHg. The incidence of TIPSS-related encephalopathy was 11.7% (95%CI: 6.3%-17.2%), and the 45-d mortality was 17.7% (95%CI: 11.34%-24.13%). CONCLUSION: TIPSS is associated with a clinically relevant response in RHH. TIPSS should be considered early in these patients, given its poor prognosis.

Original languageEnglish (US)
Pages (from-to)1797-1806
Number of pages10
JournalWorld Journal of Hepatology
Volume7
Issue number13
DOIs
StatePublished - 2015

Keywords

  • Cirrhosis
  • Hepatic hydrothorax
  • Meta-analysis
  • Portal hypertension
  • Transjugular intrahepatic portosystemic stent shunt

ASJC Scopus subject areas

  • Hepatology

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