TIPS in Patients With Refractory Ascites: Review of Literature and Current Recommendations.

In cirrhotic patients, refractory ascites (RA) is a devastating consequence of portal hypertension and is associated with high morbidity and mortality. Over the past quarter century, transjugular intrahepatic portosystemic shunt (TIPS) placement has become a key treatment for patients with RA, but there has been an evolution of patient evaluation, stents, and procedural techniques during this time. As such, the rates of ascites control, survival, and associated hepatic encephalopathy have evolved as well. This review examines the evidence and current recommendations for TIPS in the setting of RA.