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Transjugular intrahepatic portosystemic shunt

Dr Bruno Di Muzio and Dr Frank Gaillard et al.

A transjugular intrahepatic portosystemic shunt (TIPS) is a treatment for portal hypertension in which a direct communication is formed between a hepatic vein and a branch of the portal vein, thus bypassing the liver. 

Indications

Many patients have end stage liver disease. Indications include

Contraindications
Complications
  • blockage - TIPS occlusion
  • uncontrollable hepatic encephalopathy
  • hepatic venous stenosis
  • haemorrhage (haemoperitoneum, intrahepatic haematoma, subcapsular haematoma
  • sepsis secondary to infection 6
Methods to assess patency
  • color Doppler1
  • CT angiography 4
  • portography with portal manometry
Factors affecting poor survival 5
  • hyponatremia
  • hyperbilirubinemia
  • elevated serum ALT
  • advanced liver disease
  • coexisting renal insufficiency
See also

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