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TIPSS as a bridge to extrahepatic abdominal surgery: a case report
Audrey Pamela Kapeleris1, Suresh Venkatachalapathy2
1Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Oxford Medical Case Reports
|April 25, 2022
Summary
Transjugular intrahepatic portosystemic shunt (TIPSS) placement can help patients with cirrhosis and portal hypertension undergo major surgery. Careful patient selection is crucial due to risks of liver decompensation.
Area of Science:
- Hepatology
- Interventional Radiology
- Surgical Gastroenterology
Background:
- Severe portal hypertension in cirrhosis often contraindicates major surgery due to bleeding risks.
- Transjugular intrahepatic portosystemic shunt (TIPSS) is a procedure to reduce portal pressure.
Observation:
- Two patients with cirrhosis and portal hypertension underwent pre-surgical TIPSS placement.
- One patient had a successful surgery, while the other experienced post-procedure liver decompensation.
Findings:
- Prophylactic TIPSS may enable major extrahepatic abdominal surgery in select patients with decompensated cirrhosis.
- Outcomes varied, highlighting the procedure's potential benefits and risks.
Implications:
- TIPSS placement could be a viable bridging therapy for specific surgical candidates with cirrhosis.
- Careful patient selection and pre-operative counseling are essential to mitigate risks of liver decompensation.
