DOES TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNTS (TIPS) INCREASE THE RISK FOR THE GROWTH OF HEPATOCELLULAR CARCINOMA?
Anecdotal experience has suggested that an unexpected number of hepatocellular carcinomas (HCC) are found in decompensated cirrhotic patients after the insertion of a transjugular intrahepatic portosystemic stent shunt (TIPS). AIM: To determine if the incidence of HCC following TIPS insertion in decompensated cirrhosis is increased. METHODS: A case control study of decompensated cirrhotic patients, involving reviews of hospital and clinic records of TIPS patients, and non-TIPS control patients matched for gender, age, etiology and severity of liver disease, and the year of presentation was conducted. Absence of HCC as indicated by post-paracentesis ultrasound and triphasic CT scanning, and a normal alpha fetoprotein was required for inclusion at enrolment and histological diagnosis of HCC was sought at follow-up. FINDINGS: There were 98 TIPS patients and 98 control patients (mean age: 53.8±1.0 years and 54.3±0.9 years respectively) with respective mean Child-Pugh score of 8.81±0.15 and
