BSG, BASL & BSIR Guideline: Transjugular Intrahepatic Portosystemic Stent-Shunt (TIPSS) in the management of portal hypertension

Reviewed 2024


Abstract

These guidelines on transjugular intrahepatic portosystemic stent-shunt (TIPSS) in the management of portal hypertension have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the Liver Section of the BSG. The guidelines are new and have been produced in collaboration with the British Society of Interventional Radiology (BSIR) and British Association of the Study of the Liver (BASL).

The guidelines development group comprises elected members of the BSG Liver Section, representation from BASL, a nursing representative and two patient representatives. The quality of evidence and grading of recommendations was appraised using the GRADE system. These guidelines are aimed at healthcare professionals considering referring a patient for a TIPSS. They comprise the following subheadings: indications; patient selection; procedural details; complications; and research agenda. They are not designed to address: the management of the underlying liver disease; the role of TIPSS in children; or complex technical and procedural aspects of TIPSS.

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Position Statements
Liver
BSG position statement on the American Association for the Study of Liver Disease practice guidance on risk stratification and management of portal hypertension and varices in cirrhosis
clinical-resource/BSG-AASLD-position-statement-cirrhosis
The British Society of Gastroenterology (BSG) recognises that the current UK guideline on the management of variceal bleeding in cirrhotic patients (2015) requires updating.

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Clinical Resources
Allurion Gastric Balloon: Updated safety information due to the risks of gastric outlet obstruction, small bowel obstruction and gastric perforation (DSI/2026/004)
clinical-resource/MHRA-DSI-on-the-Allurion-Gastric-Balloon
In rare instances, the Allurion Gastric Balloon has not transited through the stomach or bowel as intended, leading to complications.