TIPS
Giving portal pressure somewhere to go.
TIPS creates a new channel inside the liver to relieve portal hypertension. It is used for repeated variceal bleeding and fluid in the abdomen that does not respond to medication, and is performed through a neck vein.
What patients call it
Shunt for liver pressure and variceal bleeding
At a glance
- What it does
- Giving portal pressure somewhere to go.
- Used for
- Portal hypertension · Recurrent variceal bleeding · Refractory ascites
- How it is done
- Scarred liver tissue resists the blood trying to cross it. → From a neck vein, a tract is created through the liver parenchyma. → A covered stent holds that tract open between portal and hepatic veins.
- Recovery
- Procedure: Day 0 - Tract created; portal pressure falls. Hospital stay 2-3 days. · Day 1: Monitoring for encephalopathy. Early walking encouraged.
Used for
- — Portal hypertension
- — Recurrent variceal bleeding
- — Refractory ascites
Symptoms & Causes
Symptoms
- — Ascites (fluid in abdomen)
- — Variceal bleeding
Common Causes
- — Liver cirrhosis
- — Portal hypertension
Diagnosis & Treatment
How it is diagnosed
- — Ultrasound
- — CT
- — Endoscopy
The Procedure
- — Transjugular Intrahepatic Portosystemic Shunt
Recovery & Benefits
- Procedure: Day 0 - Tract created; portal pressure falls. Hospital stay 2-3 days.
- Day 1: Monitoring for encephalopathy. Early walking encouraged.
- 1 Month: Follow-up ultrasound and normal life.
Procedure sequence
- 01
Scarred liver tissue resists the blood trying to cross it.
- 02
From a neck vein, a tract is created through the liver parenchyma.
- 03
A covered stent holds that tract open between portal and hepatic veins.
- 04
Portal pressure falls immediately and is measured on the table.
- 05
Ascites and variceal bleeding recede.
Questions patients ask
What are the side effects of TIPS?+
The main one is confusion from hepatic encephalopathy, which is watched for and usually manageable with medication and shunt adjustment.