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The liver's secret passages: How can TIPS save lives and fight the curse of esophageal varices?
In the history of medical development, miracles that occurred when and where they occurred are always fascinating.
This surgery was born out of a deep understanding of the liver and portal system and is performed by specialized interventional radiologists. It has now become an important method to combat esophageal varices and related complications.The "channel" in the liver - transcatheter intrahepatic portosystemic shunt (TIPS), is a life-and-death technological innovation that has brought hope to countless patients facing numerous difficulties due to liver disease.
The formation and history of TIPS
The concept of TIPS was first proposed by Josef Rösch of Oregon Health & Science University in the United States in 1969. In 1982, Dr. Ronald Colapinto from the University of Toronto successfully applied this technology to humans for the first time. However, the real popularization of this technology is closely related to the development of intraluminal stents in 1985, followed by the first successful TIPS surgery in 1988.
Medical Uses
The main use of TIPS surgery is to treat portal hypertension caused by liver disease, especially bleeding caused by esophageal and gastric varices. According to the results of randomized studies,
In addition, this technology has also shown certain effectiveness in the treatment of hepatorenal syndrome and ascites.if the surgery can be completed within 72 hours after the bleeding occurs, the patient's chance of survival will be significantly improved.
Surgical process and technical details
The TIPS procedure is usually performed by an experienced interventional radiologist and is performed under image guidance. The procedure is usually performed through the internal jugular vein in the neck, where a catheter is connected between the hepatic vein and the portal vein. Once in the hepatic vein, the doctor measures the pressure in the liver, then uses a special needle to penetrate the liver, connect the portal vein to the hepatic vein, and finally implant a stent to maintain the patency of this channel.
Potential complicationsLike any medical procedure, TIPS surgery carries certain risks. Although the surgical procedure has an operational mortality rate of less than 1% when the technique is mature, approximately 25% of patients experience transient hepatic encephalopathy after surgery,
which is mainly due to increased nitrogen shunting. caused by.In addition, complications such as acute liver failure and persistent TIPS infection also require special attention.
Mechanism Analysis
Portal hypertension is an important consequence of liver disease, which leads to the formation of a large number of collateral circulations. These collateral vessels are usually weak and prone to bleeding. The core of TIPS surgery is to re-clear the blood flow to the liver to reduce venous pressure and thus reduce the risk of future bleeding.
ConclusionThe surgically created channel effectively reduces portal pressure, with the attendant effect of alleviating ascites, but may take weeks or even months to take effect.
With the advancement of technology, TIPS, as a minimally invasive treatment option, has brought a new solution to portal hypertension and its complications. Through a professional medical team and continuous technological innovation, this surgical technique has entered the stage of widespread application. Therefore, we can’t help but wonder, with future advances in medical technology, will there be more similar innovations that will continue to save more lives?
