Loading...
Transjugular intrahepatic portosystemic shunt (TIPS) procedures are necessary for some patients with cirrhosis who have developed intractable ascites or bleeding gastric varices; however, TIPS is complicated by post-TIPS hepatic encephalopathy (HE) in as many as half of patients. No prophylactic interventions have been shown to prevent postprocedural HE. Therefore, French investigators randomized 186 patients with cirrhosis (mostly alcohol-induced) and undergoing TIPS to receive either rifaximin or placebo, starting 14 days before their procedures and continuing for 6 months.
Overt HE — defined as grade 2 or higher by West Haven modified criteria or isolated asterixis — occurred significantly less often in the rifaximin group (34% vs. 53%; n…