Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure to create new connections between two blood vessels in your liver. You may need this procedure if you have very bad liver problems.
This is not a surgical procedure. It is done by a radiologist using x-ray. A radiologist is a doctor who uses imaging techniques to diagnose and treat diseases.
You will be asked to lie on your back. You will be connected to monitors that will check your heart rate and blood pressure.
You will probably receive local anesthesia and medicine to relax you. This will make you pain-free and sleepy. Or, you may have general anesthesia (asleep and pain-free).
Your radiologist will insert a catheter (a flexible tube) through your skin into a vein in your neck.
This new pathway will allow blood to flow better. It will ease pressure on the veins of your stomach, esophagus, intestines, and liver.
Normally, blood coming from your esophagus, stomach, and intestines first flows through the liver. When your liver has a lot of damage and there are blockages, blood cannot flow through it very easily. This is called portal hypertension (increased pressure and backup at the portal vein).
When this problem happens, you may have:
This procedure allows your blood to flow better in your liver, stomach, esophagus, and intestines, and then back to your heart.
Potential risks for this procedure are:
Rare risks are:
Your doctor may ask you to have these tests:
Always tell your doctor or nurse:
On the day of your surgery:
After the procedure, you will recover in your hospital room. You will be monitored for bleeding. You will have to keep your head raised.
There is usually no pain after the procedure.
You will be able to go home when you feel better. This may be the day after surgery.
Many people get back to their everyday activities in 7 to 10 days.
Your doctor will probably do ultrasounds after surgery to make sure the stent is working correctly.
You will be asked to have a repeat ultrasound in a few weeks to make sure that the TIPS procedure is working.
Your radiologist can tell you right away how well the procedure worked. Most patients recover well.
TIPS works in about 80% - 90% of portal hypertension cases.
The procedure is much safer than surgery and does not involve any cutting or stitches.
TIPS
Rikkers LF. Surgical complications of cirrhosis and portal hypertension. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 53.
Shah VH, Kamath PS. Portal hypertension and gastrointestinal bleeding. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010: chap 90.
Updated by: Shabir Bhimji, MD, PhD, Specializing in Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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