Objective: To evaluate retrospectively results of TIPS treatment of patients with refractory ascites between September 1992 and end of March 2000. Authors recorded the following parameters: Etiology of liver cirrhosis, technical success of TIPS, mortality and morbidity during procedure, 30-day mortality, period of survival after TIPS, influence of hepatopathy grade according to Child-Pugh classification and patients’ survival after TIPS, necessity of TIPS revisions for stenosis in the shunt, and incidence of portosystemic encephalopathy after TIPS. Material and methods: The study included 56 patients hospitalized with the diagnosis of refractory ascites from October 1992 until March 2000. 17 women (average age 51.8 years - age range 27.9 to 65.3 years) and 38 men (average age 51.6 years – range 18.5 to 78.4 years). The most frequent cause of liver cirrhosis was alcohol in 26 patients (47%), viral hepatitis in 10 patients (18%), Budd-Chiari syndrome in 7 patients (13%), and autoimmune hepatitis in 1 patient (2%). Indication for TIPS was refractory ascites in 46 patients (83%) and refractory ascites with oesophageal varicose bleeding in 9 patients (16%). One patient was treated for combined refractory ascites and hydrothorax. TIPS was implemented by the standard Rösch-Uchida method. All patients had clinical, laboratory and ultrasound follow-up for a 3-month period. Results: Technical success of TIPS was 98% and 30-day mortality was 8.9%. 64% patients survived 12 months after TIPS, 75% from group B Child-Pugh classification and 35% from group C Child-Pugh classification (p=0.01). A good effect of TIPS on ascites was recorded in 56% patients. Relapse of ascites because of TIPS stenosis was observed in 23% of patients. TIPS did not show any effect on ascites in 5% of patients. 58% patients did not develop deterioration of encephalopathy after TIPS, 2% of patients suffered frommoderate transient encephalopathy, and 11% patients developed severe encephalopathy. 5% patients required shunt reduction because of severe encephalopathy. Conclusion: TIPS proved a safe method leading to reduction or disappearance of ascites in 79% patients. To assess the long-term TIPS survival effects, futher controlled studies are needed.

        Key words: portal hypertension - refractory ascites - TIPS