0
ARTICLE |

Invited Commentary

Robert Shields, MD, DSc
Arch Surg. 1997;132(6):632. doi:10.1001/archsurg.1997.01430300074015.
Text Size: A A A
Published online

For decades, medical and surgical hepatologists have pursued the Holy Grail of reduction in portal pressure, combined with an absence of complications and side effects. The radiologists have joined this elusive hunt with the development of TIPS. As usual in this field, early study results were most promising with apparently good control of bleeding. Technically, the procedure was demanding, but the technique became less traumatic and of shorter duration than the available invasive surgical procedures. Subsequently, in several uncontrolled large series and in smaller randomized control trials, much higher rebleeding rates were reported and the incidence of encephalopathy and liver failure gradually approached that found after surgical portosystemic shunts. The article by Tyburski et al presents a long-term study of a group of patients typically found in Western society, ie, with severe liver disease, mainly alcoholic in origin. In addition, the patients already had been selected in so far as

Topics

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();