Letter to the Editor: Abdominal Surgery in Idiopathic Noncirrhotic Portal Hypertension: Is Preemptive TIPS Reducing Postoperative Complications?

We read with great interest the article by Elkrief et al. reporting long-term outcomes of abdominal surgery in patients with idiopathic noncirrhotic portal hypertension (INCPH) In a subgroup analysis, the authors compared the outcome of patients who had (n = 33) or did not have (n = 10) a preemptive transjugular intrahepatic portosystemic shunt (TIPS), showing that TIPS before surgery had no significant impact on postoperative outcomes. This retrospective subgroup analysis had some limitations. The comparison of the clinical characteristics between the groups was performed on the data after TIPS placement, and the small sample size reduced the statistical power of the analysis. These data are still preliminary to draw any firm conclusion-as already discussed by the authors-but could potentially dissuade clinicians in using preemptive TIPS in this clinical context.