Transjugular Intrahepatic Portosystemic Shunt (TIPS) for Cirrhosis
Topic Overview
Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure
that may be used to reduce
portal hypertension and its complications, especially
variceal bleeding. A TIPS procedure may be done
by a radiologist, who places a small wire-mesh coil (stent) into a liver vein.
The stent is then expanded using a small inflatable balloon (angioplasty). The
stent forms a channel, or shunt, that bypasses the liver. This channel reduces
pressure in the portal vein. By reducing portal hypertension, enlarged veins
(varices) are less likely to rupture and bleed. And other complications of
cirrhosis called ascites (fluid in the abdomen) and hepatic hydrothorax (fluid
between the lungs and the chest wall) may improve or go away.
TIPS may be used to:
- Treat fluid buildup that continues to occur in
the abdominal cavity despite medical therapy (refractory
ascites).
- Treat acute variceal bleeding that is not controlled by
standard treatment.
- Prevent recurrent episodes of variceal bleeding
when sclerotherapy or band ligation has
failed.
- Treat variceal bleeding while someone is waiting for a
liver transplant.
Complications of the procedure may
include:
-
Encephalopathy. Up to 20 out of 100 people who
have TIPS surgery develop encephalopathy after the surgery.1
- Malfunction of the stent, such as narrowing
(stenosis) or closing (occlusion).
References
Citations
-
Bacon BR (2012). Cirrhosis and its
complications. In DL Longo et al., eds., Harrison's Principles of Internal Medicine, 18th ed., vol. 2, pp. 2592–2602. New York:
McGraw-Hill.
Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
Adam Husney, MD - Family Medicine |
|
Specialist Medical Reviewer
|
W. Thomas London, MD - Hepatology |
|
Last Revised
|
January 17, 2012 |
Last Revised:
January 17, 2012
Bacon BR (2012). Cirrhosis and its
complications. In DL Longo et al., eds., Harrison's Principles of Internal Medicine, 18th ed., vol. 2, pp. 2592–2602. New York:
McGraw-Hill.
