An update on the pathogenesis and clinical management of cirrhosis with refractory ascites

References

• European Association for the Study of the Liver. EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis. J Hepatol. 2010;53(3):397–417.
   PubMed Web of Science ®Google Scholar
• D’Amico G, Pasta L, Morabito A, et al. Competing risks and prognostic stages of cirrhosis: a 25-year inception cohort study of 494 patients. Aliment Pharmacol Ther. 2014;39(10):1180–1193.
   PubMed Web of Science ®Google Scholar
• Gordon FD. Ascites. Clin Liver Dis. 2012;16(2):285–299.
   PubMed Web of Science ®Google Scholar
• Stepanova M, De Avila L, Afendy M, et al. Direct and indirect economic burden of chronic liver disease in the United States. Clin Gastroenterol Hepatol. 2017;15(5):759–766 e755.
   PubMed Web of Science ®Google Scholar
• Morando F, Maresio G, Piano S, et al. How to improve care in outpatients with cirrhosis and ascites: a new model of care coordination by consultant hepatologists. J Hepatol. 2013;59(2):257–264.
   PubMed Web of Science ®Google Scholar
• Salerno F, Guevara M, Bernardi M, et al. Refractory ascites: pathogenesis, definition and therapy of a severe complication in patients with cirrhosis. Liver Int. 2010;30(7):937–947.
   PubMed Web of Science ®Google Scholar
• Moore KP, Wong F, Gines P, et al. The management of ascites in cirrhosis: report on the consensus conference of the International Ascites Club. Hepatology. 2003;38(1):258–266.
   PubMed Web of Science ®Google Scholar
• Piano S, Tonon M, Angeli P. Management of ascites and hepatorenal syndrome. Hepatol Int. 2018;12(Suppl 1):122–134.
   PubMed Web of Science ®Google Scholar
• D’Amico G, Morabito A, D’Amico M, et al. Clinical states of cirrhosis and competing risks. J Hepatol. 2018;68(3):563–576.
   PubMed Web of Science ®Google Scholar
• Moller S, Bendtsen F, Henriksen JH. Splanchnic and systemic hemodynamic derangement in decompensated cirrhosis. Can J Gastroenterol. 2001;15(2):94–106.
   PubMed Web of Science ®Google Scholar
• Liu H, Lee SS. Acute-on-chronic liver failure: the heart and systemic hemodynamics. Curr Opin Crit Care. 2011;17(2):190–194.
   PubMed Web of Science ®Google Scholar
• Moller S, Bendtsen F. The pathophysiology of arterial vasodilatation and hyperdynamic circulation in cirrhosis. Liver Int. 2018;38(4):570–580.
   PubMed Web of Science ®Google Scholar
• Fernandez M. Molecular pathophysiology of portal hypertension. Hepatology. 2015;61(4):1406–1415.
   PubMed Web of Science ®Google Scholar
• Adebayo D, Neong SF, Wong F. Refractory Ascites in Liver Cirrhosis. Am J Gastroenterol. 2018. doi: 10.1038/s41395-018-0185-6. [Epub ahead of print].
   PubMed Web of Science ®Google Scholar
• Schrier RW. Decreased effective blood volume in edematous disorders: what does this mean? J Am Soc Nephrol. 2007;18(7):2028–2031.
   PubMed Web of Science ®Google Scholar
• Bernardi M, Moreau R, Angeli P, et al. Mechanisms of decompensation and organ failure in cirrhosis: from peripheral arterial vasodilation to systemic inflammation hypothesis. J Hepatol. 2015;63(5):1272–1284.
   PubMed Web of Science ®Google Scholar
• Moller S, Henriksen JH, Bendtsen F. Pathogenetic background for treatment of ascites and hepatorenal syndrome. Hepatol Int. 2008;2(4):416–428.
   PubMed Web of Science ®Google Scholar
• Kumar A, Das K, Sharma P, et al. Hemodynamic studies in acute-on-chronic liver failure. Dig Dis Sci. 2009;54(4):869–878.
   PubMed Web of Science ®Google Scholar
• Stadlbauer V, Wright GA, Banaji M, et al. Relationship between activation of the sympathetic nervous system and renal blood flow autoregulation in cirrhosis. Gastroenterology. 2008;134(1):111–119.
   PubMed Web of Science ®Google Scholar
• Sole C, Pose E, Sola E, et al. Hepatorenal syndrome in the era of acute kidney injury. Liver Int. 2018;38(11):1891-1901.
   PubMed Web of Science ®Google Scholar
• Davenport A, Sheikh MF, Lamb E, et al. Acute kidney injury in acute-on-chronic liver failure: where does hepatorenal syndrome fit? Kidney Int. 2017;92(5):1058–1070.
   PubMed Web of Science ®Google Scholar
• European Association for the Study of the Liver. Electronic address European association for the study of the Liver. EASL clinical practice guidelines for the management of patients with decompensated cirrhosis. J Hepatol. 2018;69(2):406-460.
   Google Scholar
• Durand F, Graupera I, Gines P, et al. Pathogenesis of hepatorenal syndrome: implications for therapy. Am J Kidney Dis. 2016;67(2):318–328.
   PubMed Web of Science ®Google Scholar
• Claria J, Stauber RE, Coenraad MJ, et al. Systemic inflammation in decompensated cirrhosis: characterization and role in acute-on-chronic liver failure. Hepatology. 2016;64(4):1249–1264.
   PubMed Web of Science ®Google Scholar
• Tazi KA, Quioc JJ, Abdel-Razek W, et al. Protein array technology to investigate cytokine production by monocytes from patients with advanced alcoholic cirrhosis: an ex vivo pilot study. Hepatol Res. 2009;39(7):706–715.
   PubMed Web of Science ®Google Scholar
• Dirchwolf M, Podhorzer A, Marino M, et al. Immune dysfunction in cirrhosis: distinct cytokines phenotypes according to cirrhosis severity. Cytokine. 2016;77:14–25.
   PubMed Web of Science ®Google Scholar
• Giron-Gonzalez JA, Martinez-Sierra C, Rodriguez-Ramos C, et al. Implication of inflammation-related cytokines in the natural history of liver cirrhosis. Liver Int. 2004;24(5):437–445.
   PubMed Web of Science ®Google Scholar
• Mandorfer M, Schwabl P, Paternostro R, et al. Von Willebrand factor indicates bacterial translocation, inflammation, and procoagulant imbalance and predicts complications independently of portal hypertension severity. Aliment Pharmacol Ther. 2018;47(7):980–988.
   PubMed Web of Science ®Google Scholar
• Bauer TM, Schwacha H, Steinbruckner B, et al. Small intestinal bacterial overgrowth in human cirrhosis is associated with systemic endotoxemia. Am J Gastroenterol. 2002;97(9):2364–2370.
   PubMed Web of Science ®Google Scholar
• Qin N, Yang F, Li A, et al. Alterations of the human gut microbiome in liver cirrhosis. Nature. 2014;513(7516):59–64.
   PubMed Web of Science ®Google Scholar
• Bajaj JS, Heuman DM, Hylemon PB, et al. Altered profile of human gut microbiome is associated with cirrhosis and its complications. J Hepatol. 2014;60(5):940–947.
   PubMed Web of Science ®Google Scholar
• Schnabl B, Brenner DA. Interactions between the intestinal microbiome and liver diseases. Gastroenterology. 2014;146(6):1513–1524.
   PubMed Web of Science ®Google Scholar
• Pascual S, Such J, Esteban A, et al. Intestinal permeability is increased in patients with advanced cirrhosis. Hepatogastroenterology. 2003;50(53):1482–1486.
   PubMed Web of Science ®Google Scholar
• Zapater P, Frances R, Gonzalez-Navajas JM, et al. Serum and ascitic fluid bacterial DNA: a new independent prognostic factor in noninfected patients with cirrhosis. Hepatology. 2008;48(6):1924–1931.
   PubMed Web of Science ®Google Scholar
• Weil D,  Pais de Barros JP, Mourey G, et al. Circulating levels of 3-hydroxymyristate, a direct quantification of endotoxemia in non-infected cirrhotic patients. Liver Int. 2018. doi: 10.1111/liv.13916. [Epub ahead of print].
   PubMed Web of Science ®Google Scholar
• Rasaratnam B, Kaye D, Jennings G, et al. The effect of selective intestinal decontamination on the hyperdynamic circulatory state in cirrhosis. A randomized trial. Ann Intern Med. 2003;139(3):186–193.
   PubMed Web of Science ®Google Scholar
• Sola E, Sole C, Gines P. Management of uninfected and infected ascites in cirrhosis. Liver Int. 2016;36(Suppl 1):109–115.
   PubMed Web of Science ®Google Scholar
• Triantos CK, Kehagias I, Nikolopoulou V, et al. Incarcerated umbilical hernia after large volume paracentesis for refractory ascites. J Gastrointestin Liver Dis. 2010;19(3):245.
   PubMed Web of Science ®Google Scholar
• Singhal S, Baikati KK, Jabbour II, et al. Management of refractory ascites. Am J Ther. 2012;19(2):121–132.
   PubMed Web of Science ®Google Scholar
• Senousy BE, Draganov PV. Evaluation and management of patients with refractory ascites. World J Gastroenterol. 2009;15(1):67–80.
   PubMed Web of Science ®Google Scholar
• Wong F. Management of ascites in cirrhosis. J Gastroenterol Hepatol. 2012;27(1):11–20.
   PubMed Web of Science ®Google Scholar
• Morando F, Rosi S, Gola E, et al. Adherence to a moderate sodium restriction diet in outpatients with cirrhosis and ascites: a real-life cross-sectional study. Liver Int. 2015;35(5):1508–1515.
   PubMed Web of Science ®Google Scholar
• Grabau CM, Crago SF, Hoff LK, et al. Performance standards for therapeutic abdominal paracentesis. Hepatology. 2004;40(2):484–488.
   PubMed Web of Science ®Google Scholar
• Sharzehi K, Jain V, Naveed A, et al. Hemorrhagic complications of paracentesis: a systematic review of the literature. Gastroenterol Res Pract. 2014;985141:2014.
   Google Scholar
• Lin CH, Shih FY, Ma MH, et al. Should bleeding tendency deter abdominal paracentesis? Dig Liver Dis. 2005;37(12):946–951.
   PubMedGoogle Scholar
• Bernardi M, Caraceni P, Navickis RJ. Does the evidence support a survival benefit of albumin infusion in patients with cirrhosis undergoing large-volume paracentesis? Expert Rev Gastroenterol Hepatol. 2017;11(3):191–192.
   PubMed Web of Science ®Google Scholar
• Bernardi M, Caraceni P, Navickis RJ, et al. Albumin infusion in patients undergoing large-volume paracentesis: a meta-analysis of randomized trials. Hepatology. 2012;55(4):1172–1181.
   PubMed Web of Science ®Google Scholar
• Peltekian KM, Wong F, Liu PP, et al. Cardiovascular, renal, and neurohumoral responses to single large-volume paracentesis in patients with cirrhosis and diuretic-resistant ascites. Am J Gastroenterol. 1997;92(3):394–399.
   PubMed Web of Science ®Google Scholar
• Caraceni P, Riggio O, Angeli P, et al. Long-term albumin administration in decompensated cirrhosis (ANSWER): an open-label randomised trial. Lancet. 2018;391(10138):2417–2429.
   PubMed Web of Science ®Google Scholar
• Sola-Vera J, Minana J, Ricart E, et al. Randomized trial comparing albumin and saline in the prevention of paracentesis-induced circulatory dysfunction in cirrhotic patients with ascites. Hepatology. 2003;37(5):1147–1153.
   PubMed Web of Science ®Google Scholar
• Moreau R, Valla DC, Durand-Zaleski I, et al. Comparison of outcome in patients with cirrhosis and ascites following treatment with albumin or a synthetic colloid: a randomised controlled pilot trail. Liver Int. 2006;26(1):46–54.
   PubMed Web of Science ®Google Scholar
• Moreau R, Asselah T, Condat B, et al. Comparison of the effect of terlipressin and albumin on arterial blood volume in patients with cirrhosis and tense ascites treated by paracentesis: a randomised pilot study. Gut. 2002;50(1):90–94.
   PubMed Web of Science ®Google Scholar
• Tan HK, James PD, Wong F. Albumin may prevent the morbidity of paracentesis-induced circulatory dysfunction in cirrhosis and refractory ascites: a pilot study. Dig Dis Sci. 2016;61(10):3084–3092.
   PubMed Web of Science ®Google Scholar
• Singh V, Dheerendra PC, Singh B, et al. Midodrine versus albumin in the prevention of paracentesis-induced circulatory dysfunction in cirrhotics: a randomized pilot study. Am J Gastroenterol. 2008;103(6):1399–1405.
   PubMed Web of Science ®Google Scholar
• Wong F, Sniderman K, Liu P, et al. Transjugular intrahepatic portosystemic stent shunt: effects on hemodynamics and sodium homeostasis in cirrhosis and refractory ascites. Ann Intern Med. 1995;122(11):816–822.
   PubMed Web of Science ®Google Scholar
• Berres ML, Lehmann J, Jansen C, et al. Chemokine (C-X-C motif) ligand 11 levels predict survival in cirrhotic patients with transjugular intrahepatic portosystemic shunt. Liver Int. 2016;36(3):386–394.
   PubMed Web of Science ®Google Scholar
• Berres ML, Asmacher S, Lehmann J, et al. CXCL9 is a prognostic marker in patients with liver cirrhosis receiving transjugular intrahepatic portosystemic shunt. J Hepatol. 2015;62(2):332–339.
   PubMed Web of Science ®Google Scholar
• Schepis F, Vizzutti F, Garcia-Tsao G, et al. Under-dilated TIPS associate with efficacy and reduced encephalopathy in a prospective, non-randomized study of patients with cirrhosis. Clin Gastroenterol Hepatol. 2018;16(7):1153–1162 e1157.
   PubMed Web of Science ®Google Scholar
• Fagiuoli S, Bruno R, Debernardi Venon W, et al. Consensus conference on TIPS management: techniques, indications, contraindications. Dig Liver Dis. 2017;49(2):121–137.
   PubMedGoogle Scholar
• Tan HK, James PD, Sniderman KW, et al. Long-term clinical outcome of patients with cirrhosis and refractory ascites treated with transjugular intrahepatic portosystemic shunt insertion. J Gastroenterol Hepatol. 2015;30(2):389–395.
   PubMed Web of Science ®Google Scholar
• Salerno F, Camma C, Enea M, et al. Transjugular intrahepatic portosystemic shunt for refractory ascites: a meta-analysis of individual patient data. Gastroenterology. 2007;133(3):825–834.
   PubMed Web of Science ®Google Scholar
• Saab S, Nieto JM, Lewis SK, et al. TIPS versus paracentesis for cirrhotic patients with refractory ascites. Cochrane Database Syst Rev. 2006;4:CD004889.
   PubMed Web of Science ®Google Scholar
• Bureau C, Thabut D, Oberti F et al. Transjugular intrahepatic portosystemic shunts with covered stents increase transplant-free survival of patients with cirrhosis and recurrent ascites. Gastroenterology. 2017;152(1):157–163.
   PubMed Web of Science ®Google Scholar
• Bucsics T, Hoffman S, Grunberger J, et al. ePTFE-TIPS vs repetitive LVP plus albumin for the treatment of refractory ascites in patients with cirrhosis. Liver Int. 2018;38(6):1036–1044.
   PubMed Web of Science ®Google Scholar
• Tsien C, Shah SN, McCullough AJ, et al. Reversal of sarcopenia predicts survival after a transjugular intrahepatic portosystemic stent. Eur J Gastroenterol Hepatol. 2013;25(1):85–93.
   PubMed Web of Science ®Google Scholar
• Shen NT, Schneider Y, Congly SE, et al. Cost effectiveness of early insertion of transjugular intrahepatic portosystemic shunts for recurrent ascites. Clin Gastroenterol Hepatol. 2018;16(9):1503-1510.e3.
   Web of Science ®Google Scholar
• Vilstrup H, Amodio P, Bajaj J, et al. Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the American association for the study of liver diseases and the European association for the study of the liver. Hepatology. 2014;60(2):715–735.
   PubMed Web of Science ®Google Scholar
• Miraglia R, Maruzzelli L, Di Piazza A, et al. Transjugular intrahepatic portosystemic shunt using the new gore viatorr controlled expansion endoprosthesis: prospective, single-center, preliminary experience. In: Cardiovasc Intervent Radiol. 2019;42(1):78-86.
   Google Scholar
• RiChard J, Thornburg B. New techniques and devices in transjugular intrahepatic portosystemic shunt placement. Semin Intervent Radiol. 2018;35(3):206–214.
   PubMed Web of Science ®Google Scholar
• Fortune B, Cardenas A. Ascites, refractory ascites and hyponatremia in cirrhosis. Gastroenterol Rep (Oxf). 2017;5(2):104–112.
   PubMed Web of Science ®Google Scholar
• Freeman RB Jr., Wiesner RH, Harper A, et al. The new liver allocation system: moving toward evidence-based transplantation policy. Liver Transplant. 2002;8(9):851–858.
   PubMed Web of Science ®Google Scholar
• Gines A, Escorsell A, Gines P, et al. Incidence, predictive factors, and prognosis of the hepatorenal syndrome in cirrhosis with ascites. Gastroenterology. 1993;105(1):229–236.
   PubMed Web of Science ®Google Scholar
• Gines P, Cardenas A, Arroyo V, et al. Management of cirrhosis and ascites. N Engl J Med. 2004;350(16):1646–1654.
   PubMed Web of Science ®Google Scholar
• Siqueira F, Kelly T, : Saab S, et al. Refractory Ascites, pathogenesis, clinical Impact, and management. Gastroenterol Hepatol. 2009;5(9):647–656.
   Google Scholar
• Heuman DM, Abou-Assi SG, Habib A, et al. Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death. Hepatology. 2004;40(4):802–810.
   PubMed Web of Science ®Google Scholar
• Somsouk M, Kornfield R, Vittinghoff E, et al. Moderate ascites identifies patients with low Model for End-stage Liver Disease scores awaiting liver transplantation who have a high mortality risk. Liver Transplant. 2011;17(2):129–136.
   PubMed Web of Science ®Google Scholar
• Busuttil RW, Farmer DG, Yersiz H, et al. Analysis of long-term outcomes of 3200 liver transplantations over two decades: a single-center experience. Ann Surg. 2005;241(6):905–916. discussion 916–908.
   PubMed Web of Science ®Google Scholar
• Fernandez-Esparrach G, Sanchez-Fueyo A, Gines P, et al. A prognostic model for predicting survival in cirrhosis with ascites. J Hepatol. 2001;34(1):46–52.
   PubMed Web of Science ®Google Scholar
• Prohic D, Mesihovic R, Vanis N, et al. Prognostic significance of ascites and serum sodium in patients with low MELD scores. Med Arch. 2016;70(1):48–52.
   PubMedGoogle Scholar
• Biggins SW, Rodriguez HJ, Bacchetti P, et al. Serum sodium predicts mortality in patients listed for liver transplantation. Hepatology. 2005;41(1):32–39.
   PubMed Web of Science ®Google Scholar
• Elwir S, Lake J. Current status of liver allocation in the United States. Gastroenterol Hepatol. 2016;12(3):166–170.
   Google Scholar
• Alessandria C, Ozdogan O, Guevara M, et al. MELD score and clinical type predict prognosis in hepatorenal syndrome: relevance to liver transplantation. Hepatology. 2005;41(6):1282–1289.
   PubMed Web of Science ®Google Scholar
• Landaverde C, Saab S. Deciding liver transplant candidacy: tools of the trade. Liver Int. 2008;28(9):1186–1189.
   PubMed Web of Science ®Google Scholar
• Volk ML, Biggins SW, Huang MA, et al. Decision making in liver transplant selection committees: a multicenter study. Ann Intern Med. 2011;155(8):503–508.
   PubMed Web of Science ®Google Scholar
• Ojo AO, Held PJ, Port FK, et al. Chronic renal failure after transplantation of a nonrenal organ. N Engl J Med. 2003;349(10):931–940.
   PubMed Web of Science ®Google Scholar
• Pawarode A, Fine DM, Thuluvath PJ. Independent risk factors and natural history of renal dysfunction in liver transplant recipients. Liver Transplant. 2003;9(7):741–747.
   PubMed Web of Science ®Google Scholar
• Tan HK, Marquez M, Wong F, et al. 2 Hepatorenal syndrome is associated with persistently impaired renal function after liver transplantation. Transplantation. 2015;99(7):1441–1446.
   PubMed Web of Science ®Google Scholar
• Angeli P, Gines P. Hepatorenal syndrome, MELD score and liver transplantation: an evolving issue with relevant implications for clinical practice. J Hepatol. 2012;57(5):1135–1140.
   PubMed Web of Science ®Google Scholar
• Sethi A, Estrella MM, Ugarte R, et al. Kidney function and mortality post-liver transplant in the model for end-stage liver disease era. Int J Nephrol Renovasc Dis. 2011;4:139–144.
   PubMedGoogle Scholar
• Bureau C, Adebayo D, Chalret de Rieu M, et al. Alfapump(R) system vs. large volume paracentesis for refractory ascites: a multicenter randomized controlled study. J Hepatol. 2017;67(5):940–949.
   PubMed Web of Science ®Google Scholar
• Bellot P, Welker MW, Soriano G, et al. Automated low flow pump system for the treatment of refractory ascites: a multi-center safety and efficacy study. J Hepatol. 2013;58(5):922–927.
   PubMed Web of Science ®Google Scholar
• Stirnimann G, Berg T, Spahr L, et al. Treatment of refractory ascites with an automated low-flow ascites pump in patients with cirrhosis. Aliment Pharmacol Ther. 2017;46(10):981–991.
   PubMed Web of Science ®Google Scholar
• Stepanova M, Nader F, Bureau C, et al. Patients with refractory ascites treated with alfapump(R) system have better health-related quality of life as compared to those treated with large volume paracentesis: the results of a multicenter randomized controlled study. Qual Life Res. 2018;27(6):1513–1520.
   PubMed Web of Science ®Google Scholar
• Sola E, Sanchez-Cabus S, Rodriguez E, et al. Effects of alfapump system on kidney and circulatory function in patients with cirrhosis and refractory ascites. Liver Transplant. 2017;23(5):583–593.
   PubMed Web of Science ®Google Scholar
• Romanelli RG, La Villa G, Barletta G, et al. Long-term albumin infusion improves survival in patients with cirrhosis and ascites: an unblinded randomized trial. World J Gastroenterol. 2006;12(9):1403–1407.
   PubMed Web of Science ®Google Scholar
• Reiberger T, Mandorfer M. Beta adrenergic blockade and decompensated cirrhosis. J Hepatol. 2017;66(4):849–859.
   PubMed Web of Science ®Google Scholar
• Gentilini P, Bernardi M, Bolondi L, et al. The rational use of albumin in patients with cirrhosis and ascites. A Delphi study for the attainment of a consensus on prescribing standards. Dig Liver Dis. 2004;36(8):539–546.
   PubMedGoogle Scholar
• Gentilini P, Casini-Raggi V, Di Fiore G, et al. Albumin improves the response to diuretics in patients with cirrhosis and ascites: results of a randomized, controlled trial. J Hepatol. 1999;30(4):639–645.
   PubMed Web of Science ®Google Scholar
• Schindler C, Ramadori G. Albumin substitution improves urinary sodium excretion and diuresis in patients with liver cirrhosis and refractory ascites. J Hepatol. 1999;31(6):1132.
   PubMed Web of Science ®Google Scholar
• Hanafusa N, Isoai A, Ishihara T, et al. Safety and efficacy of cell-free and concentrated ascites reinfusion therapy (CART) in refractory ascites: post-marketing surveillance results. PLoS one. 2017;12(5):e0177303.
   PubMed Web of Science ®Google Scholar
• Ito T, Hanafusa N, Iwase S, et al. Effects of cell-free and concentrated ascites reinfusion therapy (CART) on symptom relief of malignancy-related ascites. Int J Clin Oncol. 2015;20(3):623–628.
   PubMed Web of Science ®Google Scholar
• Ito T, Hanafusa N, Fukui M, et al. Single center experience of cell-free and concentrated ascites reinfusion therapy in malignancy related ascites. Ther Apher Dial. 2014;18(1):87–92.
   PubMed Web of Science ®Google Scholar
• Mansour A, Watson W, Shayani V, et al. Abdominal operations in patients with cirrhosis: still a major surgical challenge. Surgery. 1997;122(4): 730–735. discussion 735–736.
   PubMed Web of Science ®Google Scholar
• Teh SH, Nagorney DM, Stevens SR, et al. Risk factors for mortality after surgery in patients with cirrhosis. Gastroenterology. 2007;132(4):1261–1269.
   PubMed Web of Science ®Google Scholar
• Jain D, Mahmood E, Vb M, et al. Preoperative elective transjugular intrahepatic portosystemic shunt for cirrhotic patients undergoing abdominal surgery. Ann Gastroenterol. 2018;31(3):330–337.
   PubMed Web of Science ®Google Scholar
• Holster IL, Tjwa ET, Moelker A, et al. Covered transjugular intrahepatic portosystemic shunt versus endoscopic therapy + beta-blocker for prevention of variceal rebleeding. Hepatology. 2016;63(2):581–589.
   PubMed Web of Science ®Google Scholar
• Sauerbruch T, Mengel M, Dollinger M, et al. Prevention of rebleeding from esophageal varices in patients with cirrhosis receiving small-diameter stents versus hemodynamically controlled medical therapy. Gastroenterology. 2015;149(3):660–668 e661.
   PubMed Web of Science ®Google Scholar