In patients who have gastro-oesophageal variceal bleeding refractory to endoscopic and drug therapy as defined by Baveno 6 critera,32 transjugular intrahepatic portosystemic stent-shunt (TIPSS) is recommended (strong recommendation, moderate-quality evidence).
由BavenoVI标准定义，对内镜和药物治疗抵抗的胃食管静脉曲张出血患者，推荐颈静脉肝内门系统支架分流术(TIPSS)（强烈推荐，中等质量的证据）。
Salvage TIPSS is not recommended where the Child-Pugh score is >13 (strong recommendation, low quality of evidence).
如果儿童Child-Pugh 评分为＞13，则不建议使用抢救TIPSS。（强烈建议，证据质量低）
In patients who have Child’s C disease (C10-13) or MELD ≥19, and bleeding from oesophageal varices or GOV1 and GOV2 gastric varices and are haemodynamically stable, early or pre-emptive TIPSS should be considered within 72 hours of a variceal bleed where local resources allow (weak recommendation, moderate quality of evidence).
在Child-Pugh (C10-13)或 MELD≥19，食管静脉曲张或GOV1和GOV2胃静脉曲张出血和血流动力学稳定，当地资源允许情况下，静脉曲张出血在72小时内早期或优先TIPSS应考虑，（弱推荐，中等质量的证据）。
However, large multi-centre randomised controlled trials (RCTs) are necessary to determine whether patients with Child’s B disease and active bleeding or with MELD 12–18 benefit from early pre-emptive TIPSS.
然而，需要大型多中心随机对照试验(RCT)来确定Child-Pugh-B和活动性出血患者或MELD12-18患者是否受益于早期的TIPSS。
In secondary prevention of oesophageal variceal bleeding, TIPSS can be considered where patients rebleed despite combination of VBL +NSBB taking into account the severity of rebleeding and other complications of portal hypertension, with careful patient selection to minimise hepatic encephalopathy (weak recommendation, moderate-quality evidence).
食管静脉曲张出血的二级预防中，指患者联合VBL+NSBB后根据再出血和门静脉高压的其它并发症的严重程度，可考虑TIPS。仔细患者选择以减少肝性脑病（弱推荐量，中等质量证据）。
Further large controlled trials are required to investigate the role of TIPSS as first-line therapy in secondary prevention (strong recommendation, low quality of evidence).
需要进一步的大型对照试验来调查TIPSS作为一线治疗在二级预防中的作用（强烈推荐，证据质量低）。
In secondary prevention of gastric variceal bleeding, TIPSS ±embolisation is recommended where patients rebleed despite endoscopic injection therapy (strong recommendation, moderate-quality evidence).
在胃静脉曲张出血的二级预防中，如果患者经内镜注射治疗仍再次出血，推荐TIPSS±栓塞（强烈推荐，中等质量的证据）。
TIPSS ±embolisation can also be considered in selected patients with large or multiple gastric varices as first-line therapy in secondary prevention (weak recommendation, moderate-quality evidence).
在有选择的大或多胃静脉曲张患者中，作为二期预防的一线治疗，TIPSS±栓塞也可以考虑（弱推荐，中等质量的证据）。
In patients with bleeding from ectopic varices refractory to local and pharmacological therapies, TIPSS usually with embolisation is suggested (weak recommendation, low-quality evidence).
对于局部和药物治疗难治的异位静脉曲张出血患者，建议TIPSS通常伴有栓塞治疗（推荐薄弱，低质量证据）。
In patients with bleeding from portal hypertensive gastropathy (PHG) refractory to NSBB and iron therapy, TIPSS may be considered (weak recommendation, low-quality evidence).
对于对NSBB和含铁制剂治疗无效的门脉高压性胃病(PHG)出血的患者，可以考虑TIPSS（弱推荐，低质量证据）。
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