Zhang JQ, Cheng DL, Zhou CZ, Xu XJ. Risk factors for hepatic encephalopathy after transjugular intrahepatic portosystemic shunt in cirrhotic patients: A comprehensive minireview. World J Hepatol 2025; 17(8): 109678 [DOI: 10.4254/wjh.v17.i8.109678]
Corresponding Author of This Article
De-Lei Cheng, MD, Chief, Department of Interventional Radiology, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, No. 17 Lujiang Road, Hefei 230000, Anhui Province, China. chengdelei@hotmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jing-Qiu Zhang, Graduate School, Bengbu Medical University, Bengbu 233030, Anhui Province, China
De-Lei Cheng, Chun-Ze Zhou, Department of Interventional Radiology, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230000, Anhui Province, China
Xin-Jian Xu, Department of Interventional Radiology, Jiangyin Hospital Affiliated to Nantong University, Jiangyin 214400, Jiangsu Province, China
Co-corresponding authors: De-Lei Cheng and Xin-Jian Xu.
Author contributions: Zhang JQ and Zhou CZ designed the overall concept and outline of the manuscript and wrote the paper; Cheng DL and Xu XJ made crucial and indispensable contributions toward the completion of the paper and thus qualified as the co-corresponding authors of the paper; Zhang JQ, Cheng DL, Zhou CZ, and Xu XJ contributed critical revision of the manuscript for important intellectual content; all authors have read and approved the final manuscript.
Supported by Hefei Natural Science Foundation, No. 202341.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: De-Lei Cheng, MD, Chief, Department of Interventional Radiology, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, No. 17 Lujiang Road, Hefei 230000, Anhui Province, China. chengdelei@hotmail.com
Received: May 20, 2025 Revised: June 11, 2025 Accepted: July 14, 2025 Published online: August 27, 2025 Processing time: 100 Days and 4.9 Hours
Abstract
Transjugular intrahepatic portosystemic shunt (TIPS) is widely used to treat portal hypertension and its complications patients with cirrhosis. However, managing post-TIPS hepatic encephalopathy (HE) remains a major clinical challenge. HE is characterized by a high incidence and a complex pathogenesis, influenced by various factors. Therefore, careful patient assessment and selection for TIPS is essential. While previous studies have identified several factors contributing to the occurrence of post-TIPS HE, there is a gap in the comprehensive integration of surgical procedural parameters and metabolic mechanisms within a multidimensional analysis. This minireview aims to optimize treatment protocols and refine management strategies by conducting a comprehensive analysis of risk factors, ultimately aiming to reduce the incidence of post-TIPS HE.
Core Tip: The pathogenesis of hepatic encephalopathy (HE) following transjugular intrahepatic portosystemic shunt (TIPS) is complex, involving numerous risk factors. It is essential to recognize that HE is a multifactorial syndrome that necessitates a thorough understanding of various contributing factors. A comprehensive approach that includes preoperative individualized risk assessment, intraoperative management of portosystemic shunting, and postoperative prognostic care can provide evidence-based strategies for optimizing patient selection for TIPS. This approach aims to reduce the risk of HE following TIPS, improving long-term prognosis.
