Transjugular Intrahepatic Portosystemic Shunt (TIPS)

Transjugular Intrahepatic Portosystemic Shunt (TIPS)

Treatment for:

Ascites, Portal hypertension

Why it’s done:

Liver disease can cause restriction of flow through the liver, resulting in elevated pressure in the circulation from the bowel to the liver (portal vein). High portal vein pressures can cause bleeding (esophageal or gastric varices), and can cause buildup of fluid in the abdomen (ascites) or the chest (hepatic hydrothorax).

How it’s done:

An interventional radiologist uses ultrasound and X-rays to guide a catheter into the vein draining the liver. A specialized needle is then passed through the inside of the liver and into the portal vein. A covered stent is placed to create a shunt from the portal vein to the hepatic vein, bypassing the liver and relieving the elevated portal vein pressure.

Level of anesthesia:

General anesthesia

Risks:

Bleeding, infection, liver failure, confusion (hepatic encephalopathy)

Post-procedure:

Most patients are admitted for several days for monitoring.

Follow-up:

Doppler ultrasound is performed 2-7 days after TIPS to make sure the shunt remains open. Follow-up is usually every 6 months afterward to monitor for any narrowing or blockage of the shunt.