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Refractory ascites, a serious complication of cirrhosis, confers a 1-year mortality risk of 20% to 50%. Current standard therapy is repeated large-volume paracentesis (LVP) or transjugular intrahepatic portosystemic shunt (TIPS) placement. Results of randomized controlled trials (RCTs) in which efficacies have been compared have yielded conflicting data. In this meta-analysis, researchers assessed the efficacies of TIPS and repeated LVP and explored sources of heterogeneity.
Two independent reviewers selected five RCTs (comprising 330 patients) and examined them using rigorous meta-analytic techniques. Measures of efficacy included ascites recurrence, encephalopathy, and mortality rates. Each trial’s methodologic quality was assessed using a…