TIPSS (Transjugular Intrahepatic Portosystemic Shunt) is a radiologically created internal vascular shunt between the portal vein and a hepatic vein by which blood bypasses the fibrotic liver and portal hypertension is reduced. It acts as a bridge to liver transplantation and has been shown to improve survival in patients with cirrhosis.This service, till recently unavailable in Eastern India, is being performed at the state of the art interventional set up in Kolkata, India.
Amit Ganguly (name changed) presented to us in Rabindranath Tagore International Institute of Cardiac Sciences, with abdominal distension, respiratory disease and pedal edema. He was seen elsewhere and was diagnosed as cirrhosis of liver. Our evaluation showed right sided pleural effusion, massive ascites and derranged liver function. i,e decompensated cirrhotic liver disease. He underwent multiple pleural and peritoneal taps,in large volumes every week. He did not give any history of artered sensorium or overt gastrointestinal bleed. The aetiology of liver disease was alcohol related.
The nature of the liver disease was explained to the relatives and the patient. The extent of his pleural effusion and ascites was hampering his day to day activities. He was advised liver transplantation. It was not feasible for the patient. So we, in consultation with our Interventional radiologist decided to offer him TIPSS (Transjugular intrahepatic portosystemic shunt). He underwent the procedure and tolerated it well. Within the next visit his pleural effusion and ascites almost disappeared and he was able to join his work in 30 days time and was able to do his normal day to day activities.
Panel of doctors who performed the TIPSS Procedure:
MD, DM (CMCH Vellore)
Hepatologist (RTIICS, Kolkata)
Dr.Shuvro H Roy Chowdhury
MBBS, FRCS, FRCR, FCIRSE, EBIR (Vienna)
Interventional Radiologist (RTIICS, Kolkata)
Dr. Vikash Toshniwal
Anaesthetist – (RTIICS, Kolkata)