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Standard therapy for patients with refractory ascites involves large-volume paracentesis (LVP), but transjugular intrahepatic portosystemic shunt (TIPS) is another option. In previous meta-analyses comparing these two approaches, TIPS was more effective for controlling ascites, but it yielded higher rates of hepatic encephalopathy and offered no survival benefit. Now, investigators have conducted another meta-analysis, this time using individual-level (rather than aggregate) data that allowed them to analyze survival as a time-dependent variable.
Five randomized, controlled trials were identified for this analysis; however, one was not included because refractory ascites was not defined according to current international criteria. Individual…