Precautions after transjugular intrahepatic portal vein shunt II (TIPS)

TIPS Transjugular Intrahepatic Portosystemic Shunt

1. Poop and pee

Stool: For patients with cirrhosis, attention should be paid to keep stool unobpatted, defecation frequency of about 1-2 days /1 time, avoid forced defecation, if necessary, drugs can be used to help defecation. In addition, we should also pay attention to the color of stool, if there is black stool and exclusion and recent diet related, we need to consider whether it is caused by blood in the stool, if necessary, timely medical treatment.

Urination: Consider recording urine volume, especially in patients with ascites. According to the principle of living within your means, urine volume is the basis for patients to drink water. Be alert to large fluctuations in urine volume over a short period of time, especially when urine volume drops sharply.

2. Identification of early complications

Early identification of complications after TIPS is very important, especially for patients with hepatic encephalopathy. For patients with hepatic encephalopathy, early and timely intervention can effectively prevent the deterioration of the disease.

Hepatic encephalopathy: changes in sleeping habits (marked by lethargy, lethargy), temperament changes, etc., can be simply tested: ask the hands to straighten, observe whether the patient has tremors.

Gastrointestinal bleeding: TIPS can significantly reduce portal vein pressure after surgery, but it does not mean that it is permanent. Gastrointestinal bleeding may occur again after surgery. Data show that the incidence of gastrointestinal rebleeding within 2 years after TIPS is about 10-20%. The patient's family members should pay attention to observe whether the patient has hematemesis, black stool, weakness, dizziness, weakness, coma, limb chills, thirst and so on when suddenly standing. You should also be wary of low fever (< 38.5℃) that lasts for about 1 week.

In addition, the obvious increase in abdominal circumference, subcutaneous bleeding, hematuria, oral bleeding, etc., should also be highly vigilant.

In addition, regular outpatient follow-up is also very important for patients undergoing TIPS surgery. It is very important to review blood ammonia, albumin, total bilirubin, liver function, alpha-fetoprotein, HBV-DNA and TIPS ultrasound every 6 months, and receive professional guidance in professional clinics.