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Z Gastroenterol 2020; 58(09): 877-889
DOI: 10.1055/a-1217-7866
Übersicht

30 Jahre transjugulärer intrahepatischer portosystemischer Shunt (TIPS) – Rückblick und Perspektive

30 Years of Transjugular Intrahepatic Portosystemic Shunt (TIPS): casting a retrospective glance and future perspectives
Michael Schultheiß
  Department Innere Medizin, Klinik für Innere Medizin II, Gastroenterologie, Hepatologie, Endokrinologie und Infektiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg
,
Dominik Bettinger
  Department Innere Medizin, Klinik für Innere Medizin II, Gastroenterologie, Hepatologie, Endokrinologie und Infektiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg
,
Robert Thimme
  Department Innere Medizin, Klinik für Innere Medizin II, Gastroenterologie, Hepatologie, Endokrinologie und Infektiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg
,
Martin Rössle
  Department Innere Medizin, Klinik für Innere Medizin II, Gastroenterologie, Hepatologie, Endokrinologie und Infektiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg
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Zusammenfassung

Der transjuguläre intrahepatische portosystemische Shunt (TIPS) wird seit 30 Jahren in der Therapie der portalen Hypertonie erfolgreich eingesetzt. In nationalen und internationalen Leitlinien ist die Indikation zur TIPS-Anlage bei Varizenblutung und refraktärem Aszites wissenschaftlich gut belegt und klar definiert. Bei seltenen Indikationen wie dem hepatorenalen Syndrom, der Pfortaderthrombose oder dem neoadjuvanten Einsatz fehlt derzeit noch eine eindeutige Studienlage. Eine wichtige Kontraindikation und klinisch bedeutendste Komplikation nach TIPS ist die hepatische Enzephalopathie (HE). Es wird versucht, die Post-TIPS HE mit technischen Weiterentwicklungen der Stents zu reduzieren.

Abstract

For 30 years the transjugular intrahepatic portosystemic shunt (TIPS) is successfully used for the treatment of portal hypertension. Indication for TIPS in relation to variceal bleeding and refractory ascites is scientifically documented and defined by national and international guidelines. For rare indications such as hepatorenal syndrome, portal vein thrombosis or the neodjuvant TIPS larger evidence-based studies are missing. An important contraindication and the leading clinical complication after TIPS is the development of hepatic encephalopathy (HE). Reduction of post-TIPS HE is therefore aimed through development of further technical enhancements of the TIPS-stents.

Schlüsselwörter

TIPS - Varizenblutung - Aszites - portale Hypertonie

Key words

TIPS - variceal bleeding - ascites - portal hypertension


Publication History

Received: 14 May 2020

Accepted: 06 July 2020

Article published online:
18 September 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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