UDCA to Prevent Post-TIPS Hepatic Encephalopathy

Inclusion Criteria: * Age 18-80 years. * Confirmed cirrhosis (biopsy, elastography, or standard radiologic/biochemical criteria). * Elective TIPS for (a) refractory/recurrent ascites and/or (b) recurrent variceal bleeding not responsive to treatment with endoscopic band ligation and beta-blockers. * Preemptive TIPS for patients with variceal bleeding and Child-Pugh C (10-13 points), patients with Child-Pugh B and active bleeding during endoscopy, or patients with hepatic venous pressure gradient (HVPG) ≥ 20 mmHg. * Ability to start study drug within 72 hours before TIPS. * Signed informed consent. Exclusion Criteria: * Contraindications to TIPS (e.g., severe heart failure ≥NYHA III, severe pulmonary hypertension, uncontrolled sepsis, advanced HCC at risk with TIPS, unrelieved biliary obstruction, Child-Pugh score \>13, main-trunk PVT if not recanalizable, technical infeasibility). * Prior OHE grade II-IV without precipitating factor; overt neurological disease affecting cognition (e.g., Parkinson's, Alzheimer's). * Current or planned ursodeoxycholic acid (UDCA) therapy for an approved indication (e.g., primary biliary cholangitis), or UDCA use within the prior 3 months. * Current/recent rifaximin use (\<3 months) or strong UDCA contraindication/hypersensitivity. * Salvage TIPS. * Non-cirrhotic portal hypertension. * Pregnancy/lactation. * Any condition that, in investigators' judgment, precludes safe participation.