TIPS proceedure

[aerorunner80, ADN, BSN, MSN, APRN]

Could anyone please explain a TIPS proceedure for me. I was in the room only briefly while the doctor was explaining it to the pt and the pt is confused and kept asking questions to all of us after the doc left and I felt like I wasn't able to answer them.

From what I gathered, a TIPS proceedure is used to take care of esophageal varicies to reduce the risk of hemmorhage and the pt is put under for it. That's all I got.

Thank you!

[jer_sd]

This is an artifical path created in the liver between systemic and portal systems. A radiologist will enter the jugular vein and form a shunt between the hepatic and portal vein. This is a procedure that is often a last ditch effort to buy patients time on the transplant list. Patients should not have right sided heart failure, and may worsen encpholopathy. In my group we prefer this to be done under general anesthesia to help with runs and comfort, at other facilities it is done under moderate sedation.

Overtime the stent will close down so the patients will need periodic revisions with angioplasty. Main surveliance is done with ultrasaound evaluation.

Often we may embolize large esophageal varicies during the procedure to be more agressive in treating variceal bleeding.

Hope that brief description helps.

Jeremy

[Daytonite, BSN, RN]

The name of the procedure (TIPS) is Transjugular Intrahepatic Portosystemic Shunt (stent-shunt) or, it could also be called Transvenous Intrahepatic Portosystemic Shunt. During the procedure the hepatic and portal veins are catheterized, angiograms are done as well as hemodynamic studies. A intrahepatic tract is created, dilated and a stent placed to maintain its integrity and patency.

This article on Medscape explains a bit about the procedure and some of the aftercare. It's a doctor article, so you are warned! However, it will give you a good idea of what the doctors are attempting to accomplish. Your job. . .to put it into simple language a patient can understand.

http://www.medscape.com/viewarticle/452962_print - "Prevention of Variceal Rebleeding -- Approach to Management"

It is a less invasive procedure than a portocaval venous anastomosis. This procedure is done by an open incision into the right side of the chest cavity of the body to expose the liver, inferior vena cava and portal vein and do a side-to-side anastomosis of the portal vein to the inferior vena cava.

[aerorunner80, ADN, BSN, MSN, APRN]

Thank you. It makes more sense now.