TRANSJUGULAR INTRAHEPATIC PORTO-SYSTEMIC SHUNT (TIPS)

Dr. K. H. Fung
Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Hong Kong

TIPS is a non-surgical means of creating a shunt between portal vein and hepatic vein for relieve of severe portal hypertension causing intractable ascites or variceal bleeding.

It is performed by interventional radiologist under fluoroscopic guidance. It can be performed under local anaesthesia.

		Approach is made from a small puncture hole in the neck. A catheter is placed via internal jugular vein into R hepatic vein.
		A curved needle (arrow) is used to puncture through the liver from right hepatic vein to portal vein.
		The trans-parenchymal tract is dilated with balloon catheter (arrow).
		A metallic stent (arrow) is inserted to maintain patency between portal vein and hepatic vein completing the shunt creation.