Li Y, Wu YT, Wu H. Management of hepatic encephalopathy following transjugular intrahepatic portosystemic shunts: Current strategies and future directions. World J Gastroenterol 2025; 31(15): 103512 [PMID: 40309228 DOI: 10.3748/wjg.v31.i15.103512]
Corresponding Author of This Article
Hao Wu, Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu 610041, Sichuan Province, China. 594264513@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Apr 21, 2025; 31(15): 103512 Published online Apr 21, 2025. doi: 10.3748/wjg.v31.i15.103512
Management of hepatic encephalopathy following transjugular intrahepatic portosystemic shunts: Current strategies and future directions
Ying Li, Yu-Tong Wu, Hao Wu
Ying Li, Hao Wu, Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Yu-Tong Wu, Chongqing Medical University-University of Leicester Joint Institute, Chongqing Medical University, Chongqing 400016, China
Co-first authors: Ying Li and Yu-Tong Wu.
Author contributions: Li Y and Wu YT reviewed literature and produced the initial draft; Wu H reviewed and edited the manuscript. All authors have read and approved the final manuscript. Li Y and Wu YT contributed equally to this work as co-first authors.
Supported by the National Natural Science Foundation of China, No. 82270649.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hao Wu, Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, No. 37 Guoxue Xiang, Chengdu 610041, Sichuan Province, China. 594264513@qq.com
Received: November 22, 2024 Revised: March 4, 2025 Accepted: April 2, 2025 Published online: April 21, 2025 Processing time: 148 Days and 1.4 Hours
Core Tip
Core Tip: Hepatic encephalopathy (HE) is the main complication following transjugular intrahepatic portosystemic shunt (TIPS), significantly impairs patients’ quality of life. Preoperative evaluation is crucial to mitigate the risk of post-TIPS HE. The shunt diameter and embolization of spontaneous portosystemic shunts should be considered according to the portal pressure gradient. Rifaximin is effective for preventing post-TIPS HE. Endovascular shunt reduction is a potential intervention for refractory HE post-TIPS. Sarcopenia is associated with post-TIPS HE, and the impact of nutritional management on HE following TIPS warrants further investigation. The efficacy of fecal microbiota transplantation in post-TIPS HE requires further validation.
