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The molecular basis of colorectal cancerThe paediatric liver transplantation program at the Université catholique de Louvain(1). (1) Presented at the Symposium “Liver transplantation and its alternatives in the third millennium”, in honour of professor Jean-Bernard Otte (Brussels,4 October 2

The outcome after Transjugular Intrahepatic Portosystemic Shunt (TIPS) for hepatic hydrothorax is closely related to liver dysfunction: a long-term study in 28 patients

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Acta gastroenterol. belg., 2007, 70, 6-10

January-March Volume 70, fasc. 1

The outcome after Transjugular Intrahepatic Portosystemic Shunt (TIPS) for hepatic hydrothorax is closely related to liver dysfunction: a long-term study in 28 patients

Jean-Yves Wilputte [1], Pierre Goffette [2], Francis Zech [3], Armando Godoy-Gepert [1], Andre Geubel [1]. Departments of [1] Gastroenterology, [2] Radiology and [3] Internal Medicine, Saint-Luc university Hospital, Universit Catholique de Louvain, Brussels, Belgium.

Objectives : Hepatic hydrothorax is a rare but challenging complication of cirrhosis. The Transjugular Intrahepatic Portosystemic Shunt (TIPS) appears as one of the most successful approach of therapy. Methods : To assess long-term efficacy and safety, we reviewed 28 patients (Child B/C : 43/57%) who underwent TIPS placement for refractory hepatic hydrothorax in our institution between 1992 and 2001. Results : The 30-days mortality was 14%, reaching 25% at 90 days. The one-year survival without liver transplantation was 41.2%. Reduction in the volume of pleural effusion and improvement in clinical symptoms was observed in 68% while a complete radiological and echographic disappearance of hydrothorax was documented in 57%. Statistical analysis showed that poor liver function was predictive of mortality and non-response. Of the different liver function parameters and in this small series, the Child-Pugh score was more discriminating than the recently described Mayo risk score. Conclusion : This study shows that TIPS is effective in the treatment of hepatic hydrothorax for selected patients. Poor liver function is a strong predictive of bad outcome. (Acta gastroenterol. belg., 2007, 70, 6-10).