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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is TIPS Procedure The Only Option For Refractory Ascites?

My Dad has ascites. He is a complicated case that has been through a lot. (liver cyst - left liver lobe resection- non-traditional Roux en Y that I believe was connected to the left hepatic duct were the laparoscopic searing did not seal - cirrhosis - with likely biliary duct damage - we do not know the condition of the common bile duct - capped drain in liver that is sitting in the right hepatic duct - likely stricture at the top of the common bile duct, etc.) My main question is if someone has refractory ascites is there any other options besides the TIPS procedure. My Dad did not respond to diuretics well. I need to ask him if he has reduced his salt intake. The Hepatologist says that despite all this he has good liver and kidney function.
Wed, 29 Aug 2018
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General & Family Physician,  's  Response
Hi,

In fact treatment of ascites is step wise. We start with low salt and diuretics and then we increase the dose of diuretics to a maximum. If that fails, we generally either do drain it repeatedly or if the patient is in good health then of course TIPS is a very good choice .

This is all only symptomatic. If the primary cause of ascites could be treated then of course that would be the best option for treatment of ascites. But unfortunately most causes are difficult to treat.

Hope I have answered your query. Let me know if I can assist you further.
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Is TIPS Procedure The Only Option For Refractory Ascites?

Hi, In fact treatment of ascites is step wise. We start with low salt and diuretics and then we increase the dose of diuretics to a maximum. If that fails, we generally either do drain it repeatedly or if the patient is in good health then of course TIPS is a very good choice . This is all only symptomatic. If the primary cause of ascites could be treated then of course that would be the best option for treatment of ascites. But unfortunately most causes are difficult to treat. Hope I have answered your query. Let me know if I can assist you further.