Transjugular intrahepatic portosystemic shunt is a more effective treatment for refractory ascites than large volume paracentesis.
However, the magnitude of its effect in terms of control of ascites, encephalopathy and survival has not been established.
Dr Deltenre and colleagues undertook a meta-analysis to compare transjugular intrahepatic portosystemic shunt to large volume paracentesis in terms of control of ascites at 4 and 12 months, encephalopathy and survival at 1 and 2 years.
The research team included 5 randomized controlled trials involving 330 patients.
|The transjugular intrahepatic portosystemic shunt group achieved more control of ascites at 12 months than the controls|
In the transjugular intrahepatic portosystemic shunt group, control of ascites was more frequently achieved at 4 months (66% versus 24%) and 12 months (55% versus 19%), whereas encephalopathy was higher (55% versus 38%).
The investigators also reported that survival at 1 year (62% versus 57%) and 2 years (50% versus 43%) were not significantly different.
Dr Deltenre concluded that, “Transjugular intrahepatic portosystemic shunt is a more effective treatment for refractory ascites than large volume paracentesis.”
“However, transjugular intrahepatic portosystemic shunt increases encephalopathy and does not improve survival.