Hepatic encephalopathy and survival after transjugular intrahepatic portosystemic shunt: Do spontaneous portosystemic shunts matter?

We read the recently published article, "Episodic overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt does not increase mortality in patients with cirrhosis," with great interest. In this article1, Nardelli S. and colleagues conducted a multicenter, non-inferiority observational study to evaluate the mortality rate in patients with and without overt hepatic encephalopathy (OHE) after elective transjugular intrahepatic portosystemic shunt (TIPS) for variceal rebleeding prophylaxis or refractory ascites.