Transjugular Intrahepatic Portosystemic Shunt For Variceal Bleeding скачать в хорошем качестве

Transjugular Intrahepatic Portosystemic Shunt For Variceal Bleeding

Transjugular Intrahepatic Portosystemic Shunt (TIPS) is a minimally invasive procedure used to treat variceal bleeding, a life-threatening complication of portal hypertension often seen in patients with cirrhosis. 🧠 What Is TIPS? TIPS involves creating a channel within the liver that connects the portal vein (which carries blood from the intestines to the liver) to the hepatic vein (which drains blood from the liver to the heart). A stent is placed to keep this channel open, allowing blood to bypass the high-pressure portal system and reduce pressure in the varices. 🩸 Why It's Used for Variceal Bleeding: Esophageal and gastric varices are swollen veins that can rupture due to high portal pressure. If endoscopic treatments (like band ligation or sclerotherapy) fail to control bleeding, TIPS is indicated. TIPS reduces portal pressure, which helps stop active bleeding and prevents recurrence. 📋 Indications: According to NICE guidelines and AASLD recommendations: Uncontrolled variceal bleeding despite endoscopic and pharmacologic therapy Recurrent variceal bleeding Secondary prophylaxis in high-risk patients Gastric variceal bleeding not amenable to endoscopic glue injection ⚠️ Risks and Considerations: Hepatic encephalopathy (due to bypassing liver detoxification) Shunt dysfunction or stenosis Not suitable for patients with severe liver failure, heart failure, or polycystic liver disease 🛠️ Advances: Use of PTFE-covered stents has improved long-term patency May be combined with variceal embolization for better control 🧪 Follow-Up: Regular imaging (Doppler ultrasound) to assess shunt function Monitoring for signs of encephalopathy or liver decompensation #Liver@