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Health Sciences › Medicine › Hepatology
Transjugular Intrahepatic Portosystemic Shunt for the Management of Medically Refractory Chylous Ascites in Cirrhosis: A Single-Institution Retrospective Analysis
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Conflicts of Interest
Identified Weaknesses
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Paper Summary
Paperzilla title
Milky Belly Be Gone! But Only 8 Patients Tried This Trick: A Tiny Study on Liver Shunts
This retrospective analysis of only eight patients explored the use of a transjugular intrahepatic portosystemic shunt (TIPS) to treat stubborn chylous ascites (milky fluid buildup) in individuals with cirrhosis who hadn't responded to other medical treatments. The study found that TIPS led to resolution of ascites in most patients (7 out of 8), with a mean transplant-free survival of 19 months, but also noted significant complications including a 25% incidence of hepatic encephalopathy and two patient deaths.
Possible Conflicts of Interest
None identified
Identified Weaknesses
Extremely Small Sample Size (N=8)
With only eight patients, the findings may not be generalizable to a larger population, and it's challenging to draw statistically robust conclusions about the efficacy and safety of TIPS for this condition.
Retrospective Design
As a retrospective study, it is susceptible to selection bias and information bias, as data was collected from existing records rather than through a controlled, pre-planned protocol, which can affect the reliability of the results.
Single-Institution Study
The results may be specific to the practices, patient demographics, and expertise of a single hospital, limiting their applicability and generalizability to other healthcare settings or diverse patient groups.
Lack of Long-Term Follow-Up
The paper itself acknowledges a lack of long-term follow-up, meaning the durability of the treatment's effects and the full spectrum of potential late complications are not adequately understood.
No Control Group
The study lacks a control group, making it impossible to compare the outcomes of TIPS against alternative treatments or standard medical management. Therefore, improvements cannot be definitively attributed solely to the TIPS procedure, nor can its comparative effectiveness be quantified.
Rating Explanation
This paper is a small, single-institution retrospective analysis with only eight patients, severely limiting the generalizability and strength of its findings. While it contributes to a sparsely researched area and describes a clinical experience, the design precludes strong conclusions about efficacy or safety. The significant adverse events (two deaths out of eight patients) also highlight potential risks not fully explored due to the study's design and size.
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File Information
Original Title:
Transjugular Intrahepatic Portosystemic Shunt for the Management of Medically Refractory Chylous Ascites in Cirrhosis: A Single-Institution Retrospective Analysis
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October 01, 2025 at 05:06 AM
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