Capital Region Health Park
711 Troy-Schenectady Rd, Suite 113
Latham, New York 12110

(518) 262-5149

Gary Siskin, MD
Meridith Englander, MD
Kenneth Mandato, MD
Allen Herr, MD
Gail Sansivero, ANP
Nancy Mitchell, FNP
Christopher Doti, FNP
Sharon Ryan, LPN

Discharge Transjugular Intrahepatic Portosystemic Shunt

DISCHARGE INSTRUCTIONS: TIPS

You have just undergone a procedure called TIPS (Transjugular Intrahepatic Portosystemic Shunt).  This procedure involves placement of a tube (or stent) through the liver in order to connect a vein on one side of the liver (the portal vein) with a vein on the other side of the liver (the hepatic vein).  This enables blood to flow easily through the liver, which reduces the pressure within the portal vein.  By doing this, we reduce the chance of bleeding into your stomach or esophagus and we reduce the accumulation of fluid (ascites) in your abdomen.

1. Even though the procedure was performed through the neck, you may feel some discomfort in the upper abdomen, which is where the stent was actually placed.  If this discomfort is severe, we may prescribe pain medication for you.  If the pain occurs after you leave the hospital, please call our office at (518) 262-5149.  After hours, you can call (518) 262-3125 and ask to speak with the interventional radiologist on call. 
   
   
2. We do suggest that a diet low in protein and salt should be considered after a TIPS procedure in order to reduce the chance of fluid accumulating in the abdomen.
   
   
3. Medications may be prescribed to you to prevent the accumulation of ammonia and other toxins in the blood.  In some patients, this accumulation can lead to confusion (which is also known as encephalopathy).  The medication often used to help prevent this is called lactulose.
   
   
4. The most important part of the follow-up program after a TIPS is attending your scheduled follow-up appointments.  At these appointments, an ultrasound examination will be performed of the liver.  This is done to make sure that blood is flowing normally through the stent.  Ultrasound is able to capture problems with blood flow before they lead to bleeding or fluid reaccumulation in the abdomen.  If a problem is detected, it is likely that we can fix it with a minor procedure.
   
   
5. The dressing on the neck can be removed after 24 hours and you can shower at that time.

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