Biliary obstruction following transjugular intrahepatic portosystemic shunt placement in a patient after liver transplantation: A case report

Table 1 Characteristics of previously published cases of transjugular intrahepatic portosystemic shunt-induced biliary strictures

Ref.	Indication for TIPS placement	Interval between TIPS placement and biliary complications	Clinical presentation	Imaging finding	Treatment	Outcome	Long-term follow-up
Peynircioglu et al[12]	OH, in HCV cirrhosis	3 mo	Jaundice, acute cholangitis	RHD stenosis by TIPS	PTC, impassable stricture, external biliary drainage	Decrease in bilirubin; sepsis due to infectious colitis, colon perforation, death	-
Duller et al [13]	OH in cirrhosis (aetiology not reported)	4 mo	Jaundice	RHD stenosis by TIPS, fistula, biloma	TIPS replacement with a polytetrafluoroethylene-covered Wallstent, biloma drainage	Regression of biloma; SSC	OLTx
Paterno et al[14]	OH, in HCV cirrhosis	Immediate	Jaundice	Malposition of TIPS in CBD, obstruction of LHD and RHD at confluence	OLTx with HJA	Uneventful recovery
Karlas et al[15]	RA in ALC	18 mo (TIPS placement); 10 mo (TIPS extension)	Jaundice	Branch of RHD compression by TIPS extension	None, non-compliant patient	-	OLTx KI for continuous alcohol abuse
Korrapati et al[1]	RA in BCS	Immediate	Cholestatic liver lesion	LHD stenosis by TIPS	ERCP with biliary stent placement	Regression of cholestasis, persistent stenosis with stent replacement at 2 mo	Not reported
Meng et al[16]	OH, in cirrhosis (aetiology not reported)	5 d	Jaundice	RHD stenosis by TIPS	PTC, impassable stricture, external biliary drainage	Normalisation of bilirubin	External drainage in situ for 2 yr, one episode of mild cholangitis
	OH, in cirrhosis due to schistosomiasis	10 d	Jaundice	RHD stenosis by TIPS	PTC, impassable stricture, external biliary drainage	Normalisation of bilirubin	Enrolled on WL for OLTx
Bucher et al[3]	RA + HRS in ALC	72 mo	Asymptomatic	Compression of segmental bile duct (SVII) by TIPS	None	-	Resolution of imaging finding after 2 yr; death due to metastatic HCC
	RA in ALC	83 mo	Asymptomatic	Compression of segmental bile duct (SVII) by TIPS, cystic congestion of the intrahepatic bile ducts (SVII)	None	-	Stable on F-U
	RA + HRS in ALC	17 mo	Jaundice	Compression of segmental bile duct (SV) by TIPS	Failed ERCP (stricture not achieved); PTC KI for ascites; ATB prophylaxis	Lost to F-U (continuous alcohol abuse)	-
	RA in BCS	0.4 mo	Cholestatic liver lesion	Stenosis of segmental bile duct (SI) by TIPS; liver abscess (SI)	Percutaneous drainage of abscess, failed ERCP (impassable stricture)	Normalisation of liver enzymes	“Unremarkable”
Zhang et al[17]	Recurrent colonic variceal bleeding due to CTPV	3 d	Jaundice	CBD stenosis by TIPS	Percutaneous and endoscopic drainage	Refractory stenosis, recurrent cholangitis; magnetassisted endoscopic biliaryduodenal anastomosis after 33 mo due to TIPS

ALC: Alcoholic liver cirrhosis; ATB: Antibiotics; BCS: Budd-Chiari syndrome; CBD: Common bile duct; CTPV: Cavernous transformation of portal vein; F-U: Follow-up; HCC: Hepatocellular carcinoma; HCV: Hepatitis C virus; KI: Contraindicated; HJA: Hepaticojejunostomy; LHD: Left hepatic duct; OH: Oesophageal haemorrhage; OLTx: Orthotopic liver transplantation; RA: Refractory ascites; RHD: Right hepatic duct; WL: Waiting list.