Information Leaflet
Irish National Liver Transplant Unit
Treatment of Portal Hypertension
- TIPS
What is Portal Hypertension?
Is abnormally high blood pressure in the Portal Vein, which supplies the liver with
blood from the intestine.
This may be due to:
1.
increased blood pressure in the portal blood vessels or
2.
resistance to blood flow through the liver.
What are Oesophageal Varices?
Portal hypertension can lead to the development of oesophageal varices, which are
large varicose veins at the lower end of the gullet and the upper end of the stomach.
Bleeding from oesophageal varices is a medical emergency and the person needs
hospital treatment immediately.
How is it treated?
A variety of ways to treat bleeding varices exist and include –
1.
2.
3.
4.
passing a tube with balloons down the gullet and inflating the balloons to exert
pressure against the bleeding veins
drug therapy that helps reduce the pressure in the portal vein
veins can be injected directly, during an endoscopy, with solution that will
cause clotting in the veins, or tied off using elastic bands
shunt operation (TIPS).
What is a Transjugular Intrahepatic Portosystemic Shunt (TIPS)?
This is a non-surgical shunt inserted into the liver to connect the hepatic and portal
veins.
The aim is to reduce the abnormally high pressure in the portal vein, reducing the risk
of bleeding from oesophageal varices.
The procedure is carried out in the radiology department under general anaesthetic
and takes 1 –2 hours.
Hepatic Vein
stent
Portal
vein
What are the complications?
1.
Stenosis (narrowing) or blockage of the metal stent.
An ultrasound will be performed to check the blood flow through the stent
post insertion.
Narrowed stents may be dilated.
Blocked stents may require insertion of another stent.
2.
Encephalopathy
Is the deterioration of brain function due to toxic substances building up in the
blood, which are normally removed by the liver. This can occur following the
insertion of a TIPS because blood will now flow directly from the portal vein
to the hepatic vein and around the body without having the toxic substances
removed by the liver.
3.
Sepsis (infection)
This can occur after the insertion of the metal stent into the liver. In order to
prevent infection occurring antibiotics will be given before the procedure and
will be continued if infection occurs.
4.
Bleeding (into the abdomen)
This is very rare and may occur after the procedure.
5.
Death occurs in 1 in 100 patients
Irish National Liver Transplant Unit,
St. Brigid’s Ward,
St. Vincent’s University Hospital,
Elm Park,
Dublin 4.
Telephone: (01) 2094511