[Transjugular intrahepatic portasystemic stent shunt (TIPSS). Indications and postoperative management]

Complications of portal hypertension, e.g. bleeding from esophageal or gastric varices or ascites, can be efficiently treated by transjugular intrahepatic portosystemic stent shunting. The most important and most frequently encountered contra-indications to this procedure are malignant liver tumors, systemic infections or hepatic decompensation, and encephalopathy. Before and after the shunt procedure, treatment of these patients must be selected and administered with due consideration for the fact that they extremely prone to bacterial infections and have many concomitant diseases, e.g. impaired renal function. To prevent early occlusion of the stent, patients receive anticoagulants in the first few days after the procedure.