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TIPS stands for transjular intrahepatic portosystemic shunt:
A transjugular intrahepatic portosystemic shunt (TIPS) is a procedure where a path is created in the liver to connect two veins, the path is called a shunt. The shunt is held open by a small tube called a stent (see picture below). The stent will be used to connect the vein that carries blood from your esophagus, stomach, intestines and spleen (Portal Vein) to one of the three veins that carries blood away from the liver to the heart (Hepatic Veins).
The normal path of blood flow to your liver is from your intestines and spleen through the portal vein. When the blood reaches the liver, it is filtered through the liver and nutrients are absorbed. The blood then drains into the hepatic veins and is carried to the heart. You have a problem with your liver that has caused increased pressure, this is called portal hypertension. This pressure buildup can cause blood to flow backward from the liver into the veins of the spleen, stomach, esophagus, and intestines, causing enlarged vessels. Occasionally these enlarged vessels can bleed, this is called variceal bleeding. This pressure can also lead to ascites or fluid in the abdomen. This condition is most commonly seen as a result of a chronic liver problem called cirrhosis (scarring of the liver).
The TIPS procedure usually takes 2 to 3 hours but can take as long as 6 hours to complete. You will have general anesthesia for this procedure, which means you will be asleep during the procedure. Dr. Christenson will use wires and catheters (thin plastic tubes) to access your hepatic veins. To gain access to the hepatic veins he will enter through the large jugular vein in your neck. He will
make a passage across the liver tissue to your portal vein and place a stent to keep the passage open. The new path will allow blood to flow directly from your portal system (esophagus, stomach, intestines, and spleen) to the vena cava (a large vein that drains blood from the upper body to the lower body and empties into the right side of the heart. This new pathway will relieve the pressure.
About 1/3 of people who have this procedure may develop or have worsening of hepatic encephalopathy (confusion, trouble concentrating, and changes in sleep patterns). Most of the time these symptoms can be managed with a medication called Lactulose. If you need to take Lactulose it is important that you take it every day and do not miss doses. Changing your diet to decrease the amount of protein may also be helpful. Dr. Christenson will also discuss this with your primary doctor. Approximately 5-10% of people may have a serious complication including but not limited to:
Please be certain that we answer all of your questions and concerns prior to the procedure.
After your procedure
When you get home:
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