Cost-Effectiveness of Early Insertion of Transjugular Intrahepatic Portosystemic Shunts for Recurrent Ascites

Treatment options for recurrent ascites resulting from decompensated cirrhosis include serial large volume paracentesis and albumin infusion (LVP+A) or insertion of a transjugular intrahepatic portosystemic shunt (TIPS). Insertion of TIPSs with covered stents during early stages of ascites (early TIPS, defined as 2 LVPs within the past 3 weeks and less than 6 LVPs in the prior 3 months) significantly improves chances of survival and reduces complications of cirrhosis compared to LVP+A. However, it is not clear if TIPS insertion is cost-effective in these patients.

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