Comparison 1. Surgical shunts versus transjugular intrahepatic portosystemic shunt (TIPS).

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 All‐cause mortality at 30 days	4	496	Risk Ratio (M‐H, Random, 95% CI)	0.94 [0.44, 1.99]
1.1 Selective shunts versus TIPS	2	272	Risk Ratio (M‐H, Random, 95% CI)	1.65 [0.62, 4.41]
1.2 Non‐selective shunts versus TIPS	2	224	Risk Ratio (M‐H, Random, 95% CI)	0.61 [0.20, 1.86]
2 All‐cause mortality at 5 years	4	496	Risk Ratio (M‐H, Random, 95% CI)	0.61 [0.42, 0.90]
2.1 Selective shunts versus TIPS	2	272	Risk Ratio (M‐H, Random, 95% CI)	0.82 [0.60, 1.13]
2.2 Non‐selective shunts versus TIPS	2	224	Risk Ratio (M‐H, Random, 95% CI)	0.48 [0.36, 0.63]
3 Variceal rebleed‐related mortality at 30 days	3	426	Risk Ratio (M‐H, Random, 95% CI)	0.18 [0.04, 0.82]
3.1 Selective shunts versus TIPS	2	272	Risk Ratio (M‐H, Random, 95% CI)	0.32 [0.03, 3.03]
3.2 Non‐selective shunts versus TIPS	1	154	Risk Ratio (M‐H, Random, 95% CI)	0.11 [0.01, 0.88]
4 Variceal rebleeding episodes at 30 days	4	496	Risk Ratio (M‐H, Random, 95% CI)	0.18 [0.07, 0.49]
4.1 Selective shunts versus TIPS	2	272	Risk Ratio (M‐H, Random, 95% CI)	0.24 [0.03, 2.19]
4.2 Non‐selective shunts versus TIPS	2	224	Risk Ratio (M‐H, Random, 95% CI)	0.15 [0.04, 0.64]
5 Number of participants transplanted at 10 years follow‐up	2	272	Risk Ratio (M‐H, Random, 95% CI)	0.46 [0.13, 1.65]
5.1 Selective shunts versus TIPS	2	272	Risk Ratio (M‐H, Random, 95% CI)	0.46 [0.13, 1.65]
6 Number of participants with reinterventions at 5 years	4	496	Risk Ratio (M‐H, Random, 95% CI)	0.13 [0.06, 0.28]
6.1 Selective shunts versus TIPS	2	272	Risk Ratio (M‐H, Random, 95% CI)	0.17 [0.09, 0.33]
6.2 Non‐selective shunt versus TIPS	2	224	Risk Ratio (M‐H, Random, 95% CI)	0.06 [0.01, 0.25]
7 Irreversible shunt occlusion at 5 years	4	496	Risk Ratio (M‐H, Random, 95% CI)	0.14 [0.04, 0.51]
7.1 Selective shunts versus TIPS	2	272	Risk Ratio (M‐H, Random, 95% CI)	0.27 [0.06, 1.34]
7.2 Non‐selective shunts versus TIPS	2	224	Risk Ratio (M‐H, Random, 95% CI)	0.06 [0.01, 0.36]
8 Encephalopathy (persistent or new‐onset) at 5 years	4	496	Risk Ratio (M‐H, Random, 95% CI)	0.56 [0.27, 1.16]
8.1 Selective shunts versus TIPS	2	272	Risk Ratio (M‐H, Random, 95% CI)	0.96 [0.69, 1.33]
8.2 Non‐selective shunts versus TIPS	2	224	Risk Ratio (M‐H, Random, 95% CI)	0.35 [0.23, 0.54]
9 Ascites (persistent and new‐onset) at 5 years	2	272	Risk Ratio (M‐H, Random, 95% CI)	0.93 [0.60, 1.44]
9.1 Selective shunts versus TIPS	2	272	Risk Ratio (M‐H, Random, 95% CI)	0.93 [0.60, 1.44]
10 Survival at 5 years by Child class	2		Risk Ratio (M‐H, Random, 95% CI)	Subtotals only
10.1 Child‐Pugh class A	2	224	Risk Ratio (M‐H, Random, 95% CI)	9.06 [0.16, 521.82]
10.2 Child‐Pugh class B	2	224	Risk Ratio (M‐H, Random, 95% CI)	0.75 [0.04, 13.80]
10.3 Child‐Pugh class C	2	224	Risk Ratio (M‐H, Random, 95% CI)	0.99 [0.01, 96.10]