Abstract
This study aims to search, evaluate, and summarize the existing evidence on perioperative nutritional management of transjugular intrahepatic portosystemic shunt (TIPS) in patients with cirrhotic portal hypertension (CPH) and provide the basis for evidence-based clinical practice. According to the “6S” model of evidence-based sources, the evidence on perioperative nutrition management of TIPS in patients with CPH from relevant databases and websites was systematically searched, including clinical decisions, guidelines, expert consensus, systematic review, and evidence summary. The search range is from the establishment of the databases to August 17, 2024. Two authors independently screened the literature following the inclusion and exclusion criteria. The quality of the literature was evaluated by a total of 4 authors using appropriate tools, including Appraisal of Guidelines for Research and Evaluation II (AGREE II), the evaluation tool of the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center, and CASE (Critical Appraisal for Summaries of Evidence). Two authors were responsible for extracting and summarizing the evidence. The level of evidence was classified according to the JBI Evidence Pre-Classification and Evidence Recommendation Level System (2014 version). A total of 18 articles were included, including 3 clinical decisions, 6 guidelines, 6 expert consensuses, 2 evidence summaries, and 1 systematic review. 30 pieces of evidence covering 5 key themes were summarized: nutritional risk screening and status assessment, nutritional goals, nutritional support modalities and measures, nutritional management of complications, and follow-up and education. This study systematically retrieved and evaluated the existing evidence on perioperative nutritional management in patients with CPH undergoing TIPS. On the basis of the current level of evidence, this study proposed a preliminary framework for perioperative nutritional management and suggests that future high-quality prospective studies be conducted to further clarify the relevant recommendations. In clinical practice, healthcare professionals should exercise professional judgment, integrating clinical conditions with patient preferences, habits, and tolerability when applying the evidence.
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Subjects
- Malnutrition
- Nutrition
- Patient education
Data availability
The data that support the findings of this study are available from the corresponding author upon reasonable request
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Acknowledgements
We sincerely thank Professor Qing Li of Nutrition from the Nutrition Department of Nanfang Hospital of Southern Medical University for her valuable guidance and insightful suggestions throughout the study. We thank all the authors for their valuable contributions in implementing the methodology of this article. We would like to thank the diligent efforts of the reviewers and editors, whose constructive suggestions and criticisms played an important role in improving the overall quality of this manuscript.
Funding
This study was supported by the National Natural Science Foundation of China (82472079), the President’s Fund of Nanfang Hospital, Southern Medical University (2022H009) and the Evidence-Based Nursing Project of Nanfang Hospital, Southern Medical University (2025EBNc002)
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These authors contributed equally: Yao Liu, Xinyu Zhao
Authors and Affiliations
Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
Yao Liu, Fan Zhang, Yongqi Liang, Jianbo Zhao & Jingping He
School of Nursing, Southern Medical University, Guangzhou, China
Xinyu Zhao & Huimin Zhai
Department of Occupational Health and Occupational Medicine, School of Public Health, Southern Medical University, Guangzhou, China
Bin Wang
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Contributions
YL and BW were responsible for the methodology design. XZ, FZ, YL, and JH conducted the literature search and screening and evaluated the quality of the literature. JZ and XZ conducted evidence extraction and synthesis. XZ was responsible for writing the manuscript. YL, BW, and HZ contributed to the discussion and conclusion of the article
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Liu, Y., Zhao, X., Zhang, F. et al. Summary of the evidence for perioperative nutritional management of TIPS in patients with cirrhotic portal hypertension.
Eur J Clin Nutr (2026). https://doi.org/10.1038/s41430-026-01802-6
Received:01 September 2025
Revised:29 May 2026
Accepted:22 July 2026
Published:30 July 2026
Version of record:30 July 2026
DOI
:https://doi.org/10.1038/s41430-026-01802-6
