Transjugular intrahepatic portosystemic shunt: Nursing approach

Introduction: Transjugular intrahepatic portosystemic shunt (TIPS) is a valuable alternative to surgery in patients with acute or recurrent variceal bleeding. Variceal bleeding is a serious, lifethreatening condition rendering the particular treatment essential for the survival of the patient. Aim: To show how important the role of the nurse is during the placement of the TIPS based on recent international bibliography. Material – method: For the research elaboration both Greek and international bibliographies have been reviewed, particularly emphasising on Medline indexed nursing articles. Results: The results of the present review showed that bleeding due to oesophageal varices is a serious and often fatal complication of portal hypertension in patients with hepatic cirrhosis. Currently available treatments include various procedures such as balloon tamponade, endoscopic and surgical interventions, and radiological interventional techniques (TIPS). The most important indication for the placement of the TIPS is the treatment of acute variceal bleeding and / or the prevention of recurrence in patients not responding to standard endoscopic therapy and medical treatment and their general condition does not allow surgical treatment. According to the literature, is the ideal solution for patients with hepatic disease at an advanced stage that is scheduled for liver transplantation, when there is no alteration in the intraabdominal anatomic elements and the way they are related. Conclusions: It is important for the nursing staff to be familiar with this newly developed technique. The well-trained and well-informed nurse can play an essential role in evaluating the clinical course of the patient before, during and after the procedure, and in recognizing whether the therapy objectives have been achieved or not.