Selection of therapeutic timing of transjugular intrahepatic portosystemic shunt in patients with acute esophagogastric variceal bleeding
Acute variceal bleeding(AVB)is one of the most common complications in the patients with liver cirrhosis,seriously threatening the life safety of the patients.The application of transjugular intrahepatic portosystemic shunt(TIPS)in the treatment of AVB patients has become an important therapeutic approach.However,the selection of TIPS treatment timing has always been a challenging issue for clinical physicians.Priority TIPS treatment can improve the survival rate of high-risk patients and reduce the rebleeding rate,but its effectiveness for other patients remains unclear.Currently,elective TIPS treatment is still a second-line treatment regimen for preventing variceal rebleeding.This paper discussed from the angle of the priority TIPS,alternative TIPS and salvage TIPS in order to provide reference for the clinicians'decision-making and help to better grasp the timing selection and matters needing attention of TIPS treatment,thus enhancing the treatment efficacy and patients'survival rate.