Skip navigation
MedlinePlus Trusted Health Information for You U.S. National Library of MedicineNational Institutes of Health
Contact Us FAQs Site Map About MedlinePlus
español Home Health Topics Drugs & Supplements Medical Encyclopedia Dictionary News Directories Other Resources

 

Medical Encyclopedia

Other encyclopedia topics:  A-Ag  Ah-Ap  Aq-Az  B-Bk  Bl-Bz  C-Cg  Ch-Co  Cp-Cz  D-Di  Dj-Dz  E-Ep  Eq-Ez  F  G  H-Hf  Hg-Hz  I-In  Io-Iz  J  K  L-Ln  Lo-Lz  M-Mf  Mg-Mz  N  O  P-Pl  Pm-Pz  Q  R  S-Sh  Si-Sp  Sq-Sz  T-Tn  To-Tz  U  V  W  X  Y  Z  0-9 

Transjugular intrahepatic portosystemic shunt (TIPS)

Printer-friendly versionEmail this page to a friend
Contents of this page:

Alternative Names   

TIPS

Definition    Return to top

Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure to treat complications of severe liver disease. Such complications include bleeding from the esophagus or stomach and the accumulation of fluid in the abdomen. The cause of these complications is high pressure in blood vessels of the liver called portal veins.

The procedure involves inserting a stent (tube) to connect the portal veins to adjacent blood vessels that have lower pressure. This relieves the pressure of blood flowing through the diseased liver and can help stop bleeding and fluid back up.

Description    Return to top

The procedure is typically performed by radiologists. Many patients receive a local anesthesia to numb a small area of the skin plus sedative and pain medications. In certain cases, general anesthesia may be used, where the patient goes to sleep.

A needle is initially placed in the jugular vein in the right side of the neck to make a small hole. Needles and long, thin tubes called catheters can then be advanced down to the veins in the liver.

A needle is inserted to make a connection between an adjacent vein and a branch of the portal vein. This channel is then expanded, and a tube called a stent is inserted to allow blood to flow more easily through the liver. This tube is left in place.

Why the Procedure is Performed    Return to top

This procedure is used to treat complications of severe liver disease, when the patient has not responded to less invasive treatments (such as salt restriction in the diet and medications called diuretics to remove fluid).

Risks    Return to top

At the time of the procedure, the risks include:

Because people with severe liver disease are also at risk for encephalopathy (deterioration of brain function), this is another common complication after the TIPS has been inserted and it may require treatment. A patient who has had significant encephalopathy may not be a good candidate for TIPS.

Blockage of the TIPS occurs in most patients within the first year of placement of the TIPS. This may lead to recurrent bleeding or reaccumulation of fluid. If this occurs, the TIPS can be expanded, or a new TIPS may be created.

Death has been reported after TIPS placement. The risk is associated with the complications listed above at the time of the procedure. In addition, deaths have been reported due to worsening liver failure that occurs in the days and weeks after TIPS placement. Patients with more advanced liver disease are at greater risk for worsening liver failure after TIPS placement.

Outlook (Prognosis)    Return to top

The patient is typically monitored after the procedure, as he or she wakes up from the anesthesia. An ultrasound is commonly performed the morning after the procedure to document that the TIPS is open and functioning well.

Recovery    Return to top

The main goal during the recovery period is to watch for signs of complications. Anesthesia helps prevent pain at the time of the procedure, and there is often little, if any, discomfort after the procedure.

Update Date: 7/25/2006

Updated by: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-TorresdaleHospital, Jefferson Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

A.D.A.M. Logo

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 1997-2008, A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.