MANAGEMENT OF BUDD-CHIARI SYNDROME WITH DIPS PROCEDURE

Abstract

Objectives: To evaluate the safety, technical success, and clinical outcomes of direct intrahepatic portosystemic shunt (DIPS) in patients with BCS who were unsuitable for conventional TIPS.

Methodology: This prospective observational study was conducted at the AFIRI, Rawalpindi, and included 20 patients with confirmed BCS deemed unsuitable for TIPS due to hepatic vein thrombosis or occlusion. Diagnosis was established using Doppler ultrasonography and contrast-enhanced CT or MRI. All patients underwent ultrasound -guided DIPS via trans jugular access. Clinical, laboratory, and hemodynamic parameters were recorded pre- and post-procedure. Shunt patency, survival, and quality of life were assessed during follow-up. Statistical analysis was performed using SPSS, with a p-value <0.05 considered significant.

Results: The mean patient age was 38.6 ± 11.2 years. Technical success was achieved in 95.6% of cases. The mean portosystemic pressure gradient decreased significantly from 22.4 ± 4.6 mmHg to 9.8 ± 2.9 mmHg (p < 0.001). Significant improvement was observed in liver function tests and ascites resolution (82.3%).

Conclusion: DIPS is a safe and effective alternative to TIPS in selected patients with Budd–Chiari syndrome, offering durable portal decompression and favorable clinical outcomes.