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Transjugular intrahepatic portal-systemic shunt

Authoring team

This is an intrahepatic procedure which is used for:

  • the treatment of acute oesophageal variceal bleeds which fail to respond to drugs or sclerotherapy
  • the prevention of variceal bleeds

The advantages of TIPSS include:

  • abdominal anatomy is not disturbed which makes subsequent liver transplantation easier
  • it is a minimally invasive technique

The procedure comprises:

  • puncture of the right internal jugular
  • cannulation of the hepatic vein with screening
  • the passage of a biopsy needle through the parenchyma of the liver into a large branch of the hepatic portal vein
  • the use of angioplasty balloons and metallic stents to enlarge and maintain the porta-systemic shunt

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