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Gastroenterology Research and Practice
Volume 2013 (2013), Article ID 398172, 5 pages
http://dx.doi.org/10.1155/2013/398172
Research Article

Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt in Patients with Recurrent Variceal Hemorrhage

1Institute of Radiology, University Medical Centre Ljubljana, Zaloška cesta 7, 1525 Ljubljana, Slovenia
2Department of Ginecology, University Medical Centre Ljubljana, Zaloška cesta 7, 1525 Ljubljana, Slovenia
3Department of Gastroenterology and Endoscopy, University Medical Centre Maribor, University of Maribor, Ljubljanska Ulica 5, 2000 Maribor and Medical Faculty, Slomškov trg 15, 2000 Maribor, Slovenia

Received 14 September 2012; Accepted 22 December 2012

Academic Editor: Everson Artifon

Copyright © 2013 Popovič Peter et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. The purpose of this study was to determine the incidence and predictors of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) and endoscopic therapy (ET) in the elective treatment of recurrent variceal hemorrhage. Methods. Seventy patients were treated with elective TIPS and fifty-six patients with ET. Median observation time was 46.28 months in the TIPS group and 42.31 months in the ET group. Results. 30 patients (42.8%) developed clinically evident portosystemic encephalopathy in TIPS group and 20 patients (35.6%) in ET group. The difference between the groups was not statistically significant ( ; test). The incidence of new or worsening portosystemic encephalopathy was 24.3% in TIPS group and 10.7% in ET group. Multivariate analysis showed that ET treatment ( ), age of years ( ), pre-existing HE ( ), and Child's class C ( ) values were independent predictors for the occurrence of HE. Conclusions. Procedure-related HE is a complication in a minority of patients treated with TIPS or ET. Patients with increased age, preexisting HE, and higher Child-Pugh score should be carefully observed after TIPS procedure because the risk of post-TIPS HE in these patients is higher.