The outcome after transjugular intrahepatic portosystemic shunt (TIPS) for hepatic hydrothorax is closely related to liver dysfunction: a long-term study in 28 patients

Acta Gastroenterol Belg. 2007 Jan-Mar;70(1):6-10.


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.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Hydrothorax / etiology
  • Hydrothorax / surgery*
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / mortality
  • Male
  • Middle Aged
  • Portasystemic Shunt, Transjugular Intrahepatic*
  • Survival Rate