Jefferson University Hospitals

Portal Hypertension Surgery

Portal hypertension occurs when the veins that serve the abdominal organs become blocked, creating increased blood pressure. If the veins are blocked or compressed, the blood backs up into the abdomen. One result is for fluid to settle in the abdomen. Another is an enlarged spleen. There may be gastrointestinal bleeding or varicose veins may form in the stomach and esophagus.

What Does Portal Hypertension Surgery Involve?

If you are experiencing this condition and are still maintaining good liver function, you may be a candidate for portal hypertension surgery where surgeons use a "shunt" to help relieve the pressure within the blood vessels.

Transjugular Intrahepatic Portosystemic Shunts (TIPS)

If you are living with end-stage liver disease or cirrhosis and have developed either bleeding from varices or fluid in the abdomen, your physician may recommend placing transjugular intrahepatic portosystemic shunts to eliminate the bleeding and reduce or eliminate the need for drainage.

An expert interventional radiologist at Jefferson will carefully advance a needle from the vein that drains the liver into the portal vein. This procedure decompresses the liver. Patients are admitted the night following TIPS placement and followed closely thereafter with regular screening ultrasound studies performed to ensure that the shunt is working properly. When needed, repairs or revisions can be done as an outpatient procedure.

Until the early 1990s, the only treatment available for portal hypertension was a complex surgical procedure that carried a mortality rate greater than 50 percent and required a long hospitalization, often lasting several weeks. In contrast, patients who undergo TIPS are usually discharged within 36 hours.

Our multidisciplinary team at Jefferson will take a comprehensive approach to your liver or biliary disease. Hepatologists from our well-regarded Digestive Health Institute in the Division of Gastroenterology and Hepatology work in close collaboration with our team, too.