TIPS (TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT)/DIPS(DIRECT INTRAHEPATIC PORTO-SYSTEMIC SHUNT)
What is TIPS/DIPS:
- TIPS = Transjugular (via jugular vein)
Intrahepatic (within the liver)
Porto-systemic (between a portal vein and a hepatic vein)
Shunt (stent that is used to route blood flow within or between different organs).
DIPS (Direct intrahepatic Porto-systemic shunt)
Why it is necessary:
- Mainly useful for patients having liver cirrhosis, liver failure or portal hypertension.
- To prevent bleeding from varices, Over 90% of people that undergo TIPS will have a relief in their symptoms and experience little to no bleeding thereafter.
- For refractory ascites, 60-80% of people will have relief in their ascites. Some of these patients will no longer require paracentesis (a procedure where a needle is placed into the abdominal cavity to drain away excessive fluid). Other patients will still need paracentesis, but much less often than before the TIPS procedure.
- For other liver conditions like Budd-Chiari syndrome, many patients will have a return to nearly normal liver function once the congested blood drains through the TIPS.
Preparation for procedure:
- Few basic blood investigations like LFT, CBC, PT/INR, viral markers.
- Fasting for 4-6 hrs.
- Bring all the records including imaging record.
- Signing consent form.
What are risk:
- Stent block.
- Pain, bleeding (less than 5 cases in 100) and fever (less than 1 case in 1000).
Stent block can be detected early through regular ultrasound scans performed every three months. Once an area of narrowing has been identified, it can be treated with a balloon to widen the area of blockage (angioplasty). The angioplasty restores normal blood flow through the TIPS. This procedure, known as a TIPS revision, can be performed as a day procedure on an outpatient basis.
