Transjugular portosystemic shunt (TIPS) is a treatment modality used to lower portal hypertension, or excessive pressure in the portal vein.
This vein is responsible for carrying blood from your abdomen to your liver. Excess pressure can lead to significant bleeding and fluid buildup in the abdomen, known as ascites.
Keep reading to learn more about the TIPS procedure, including why you need it, how doctors do it, and the possible side effects that may result from the procedure.
The TIPS procedure involves creating a shunt between the portal vein and the hepatic vein by placing a stent. Here are each of the three parts of the procedure:
- shunt: Something that redirects or redirects the flow from its normal path.
- Portal vein: The vein that carries blood from the digestive tract, gallbladder, pancreas, and spleen on its way to the liver.
- Hepatic vein: The veins (usually three) that return blood that does not have oxygen from your liver to your heart.
specialist known as Interventional Radiologist The procedure will be performed, usually in a specialized operating suite known as an interventional radiology suite. During this time, the interventional radiologist will use X-ray guidelines to place the shunt.
Those who need a TIPS are usually moderately to severely ill.
Examples of acute conditions and events that may require a TIPS procedure include:
- Budd-Chiari syndrome: A rare disorder that affects the ability of blood to leave the liver, resulting in portal hypertension.
- Hepatobiliary Syndrome: A syndrome that occurs in people with serious liver disease that affects the ability of their lungs to function well.
- Hepatorenal syndrome: A condition in which a person has significant liver failure that also affects the way the kidneys work.
- Portal hypertensive gastropathy: Bleeding in the stomach and stomach lining due to portal hypertension.
- thermal hydrocephalus Ascites (extreme flatulence in the abdomen) that does not respond to conventional treatments.
- Resistant hepatic ascites: Severe pleural effusion (fluid buildup outside the lungs) resulting from serious liver disease.
- Varicose bleeding: A condition that causes profuse bleeding in the veins in the esophagus or stomach.
As you can probably tell from these pointers, the liver is an important receiver and transporter of blood in your body. When the liver does not function well, its poor function can affect many organ systems and cause symptoms that can become indications for a TIPS procedure.
Doctors usually perform TIPS after other first-line treatments have failed. For example, doctors may try to reduce ascites by draining excess fluid or varicose veins by tying or stopping bleeding in the esophagus. If these fail, the doctor may recommend a TIPS procedure.
As with any procedure, the TIPS procedure is not without side effects. Those who need this procedure are often very sick, which can increase the risk of side effects. The doctor should accurately explain the pros, cons, and risks of the procedure.
Doctors perform TIPS under general anesthesia (where you are completely asleep and unaware) or under conscious sedation. While the methods may vary based on the person, here are some basic steps for doing TIPS:
- The interventional radiologist will cannulate (access) the right jugular vein.
- The radiologist will advance the catheter into the right hepatic vein.
- The doctor will use ultrasound guidelines to identify the portal veins.
- After the portal veins are identified, the surgeon will place a stent that extends to where the hepatic vein and the inferior vena cava meet.
- The doctor may also have to embolize (heat destroy) other bleeding areas in your body.
- The doctor will measure pressures in the portal veins as well as the right atrium of your heart to make sure the shunt is working properly. They will also measure the blood flow velocity via ultrasound to ensure blood is flowing through the shunt appropriately.
- Your doctor will remove the catheter, and you will be taken to a recovery unit after anesthesia, where health care professionals will monitor you closely.
TIPS procedure usually takes between 1 and 2 hours.
However, if your case is very complex, the procedure may take longer.
Some people should not have a TIPS procedure. People who should never submit to Include TIPS Procedures those with:
- bile duct obstruction
- Liver cysts that impair the ability to advance or place a stent
- Right heart failure
- Sepsis or severe systemic infection
- severe pulmonary hypertension
The mortality rate for the TIPS procedure is less than 1%The 30-day mortality rate is less than 3%. This means that after 30 days, 97% of people who underwent the operation survive.
The The most common causes of death Of the TIPS procedure are organ failure and hemophilia or bleeding within the biliary system.
Probably stay in hospital For at least 24 hours after the TIPS procedure. This allows medical staff to monitor blood pressure, heart rate, circulation, and urine output. Your doctor will monitor other blood tests that indicate how well your heart and liver are working and make sure you don’t have any internal bleeding.
Before you are allowed to go home, your doctor will perform an ultrasound of your abdomen to determine how well blood is flowing in the portal vein and to make sure that the stent is working appropriately.
The TIPS procedure does not treat the underlying disorders that lead to ascites and bleeding. As a result, doctors do not consider it
Often, those undergoing a TIPS procedure may be on the list for a liver transplant, which can correct the underlying disorder(s).
Here are some frequently asked questions after the TIPS procedure.
Is there a special diet after the TIPS procedure?
Your doctor may advise you to eat a healthy diet after the TIPS procedure. Examples of interventions include a low-protein diet and a low-sodium diet. Immediately after the procedure, your doctor may recommend eating no more than 20 grams of protein Daily for 3 days to reduce the risk of side effects after surgery.
Will I need a liver transplant after the TIPS procedure?
Over time, a TIPS procedure can reduce liver function. The effect is likely due to Decreased blood flow to the liver. Reasons why you need a TIPS procedure and undergo the TIPS procedure itself may be indications for a liver transplant. However, there are many factors that influence if you need a liver transplant. You should discuss whether you are a candidate given your age and general health.
What is the life expectancy after a liver TIPS procedure?
TIPS can reduce a person’s mortality rate compared to no intervention. Those who do not undergo TIPS procedures but may be candidates with a mortality rate of 40% Compared with those who underwent TIPS procedures, whose mortality ranges between 20% and 35%.
The TIPS procedure can lower portal hypertension without the need for major open surgery. Since the procedure does not correct the underlying issues of liver dysfunction, you may need further treatments to improve your liver health after the procedure. Your doctor should carefully explain the risks and benefits of the procedure to you before undergoing it.