What Is a Transjugular Intrahepatic Portosystemic Shunt?

Transjugular intrahepatic portosystem stent-shunt (TIPSS).

Transjugular intrahepatic portal stent shunt

Transjugular intrahepatic portosystem stent-shunt (TIPSS).

The principle is to use special interventional treatment equipment, guided by X-ray perspective, through the jugular vein approach, to establish an artificial shunt channel between the hepatic vein and the main branch of the portal vein in the liver, and maintain its permanent with a metal inner stent Unobstructed, to reduce portal hypertension and control and prevent esophageal gastric varices rupture and bleeding, and promote ascites absorption.

Chinese name

Transjugular intrahepatic portal stent shunt

Foreign name

transjugular intrahepatic portosystem stent-shunt

Short name

TIPSS

Definition

Medical method

Alias

Transjugular intrahepatic portosystemic shunt

Transjugular intrahepatic cholangiography (Hanafee), 1967

Establishment of TIPS Animal Model (Roesch & Hanafee)

Airbag expansion TIPS channel (Colapinto) in 1983

Animal experiments with Palmaz in 1985

Human Application of Richter 1989 (Germany)

Preoperative

Diagnosis of liver function and liver vascular anatomy before interventional treatment

Medical preparation for non-emergency cases with shunt surgery (anti-infection corrects water and electrolyte disturbances to prevent blood preparation for hepatic encephalopathy)

Postoperative

Observe and prevent possible complications and deal with them in a timely manner (hemorrhagic hepatic encephalopathy, etc.)

Anticoagulant therapy

Detect TIPS patency and necessary intervention

Common equipment

Richter puncture needle features: can be used in ultrasound guidance

Rups 100 (Cook) Features: Small puncture and small damage

Operation method

Jugular vein puncture

Selective hepatic vein intubation

Intrahepatic portal vein puncture and establishment of operation channel

Measuring portal vein pressure and safety of bypass channels

Expansion of shunt channel and placement of internal stent

Portal venography and stent adjustment

1. Technical difficulties in puncturing the portal vein branch into TIPS.

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Major disadvantages

Non-one-time operation

Difficulty and technicality of operation

Challenges and future

Restenosis and occlusion of the shunt channel (quality control, anticoagulation, etc. with membrane stent irradiation)

TIPS follow up ultrasound and modern imaging technology

Improvement of TIPS technique

Large-scale comparative study answers questions about timing of treatment

Study on the mechanism of TIPS restenosis