TIPS (Transjugular Intrahepatic Portosystemic Shunt) Procedure: Pre-Op & Post-Op Care
Pre-operative Care
Pre-operative preparation for the TIPS procedure focuses on ensuring patient safety and selecting the right candidates for optimal outcomes. A comprehensive medical evaluation is performed, including liver function tests, kidney function tests, coagulation profile, and imaging studies such as Doppler ultrasound, CT scan, or MRI to assess liver anatomy and blood flow. Doctors also review the patient’s history of liver disease, prior bleeding episodes, ascites, and current medications. Blood thinners and certain drugs may be temporarily stopped to reduce bleeding risk. Patients are usually advised to fast for 6–8 hours before the procedure. In some cases, medications may be given to reduce the risk of infection or hepatic encephalopathy. Detailed counselling is provided so patients understand the procedure, benefits, possible risks, and post-procedure expectations.
Intra-operative Care
During the TIPS procedure, strict sterile techniques and continuous monitoring are maintained to ensure safety and precision. The procedure is typically performed in an advanced interventional radiology suite under local anaesthesia with sedation or general anaesthesia, depending on the patient’s condition. A catheter is inserted through the jugular vein in the neck and guided to the liver using fluoroscopic (real-time X-ray) imaging. The radiologist creates a tract between the portal vein and hepatic vein and places a stent to establish a new pathway for blood flow. Throughout the procedure, vital parameters such as heart rate, blood pressure, oxygen levels, and neurological status are closely monitored. The use of advanced imaging technology helps ensure accurate stent placement and reduces the risk of complications.
Post-operative Care
Post-operative care after a TIPS procedure is crucial for recovery and long-term success. Patients are monitored in a recovery unit or intensive care setting for the first 24 hours to detect any early complications such as bleeding, infection, or changes in mental status. Regular assessment of liver function and neurological status is important, as some patients may develop hepatic encephalopathy. Most patients can start light activities within a few days, but they are advised to avoid strenuous activity for a short period. Follow-up care includes routine Doppler ultrasound to check shunt patency and blood flow, along with scheduled clinical evaluations. Long-term management may involve dietary modifications, medications, and lifestyle changes to support liver health and prevent recurrence of symptoms.
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