Liver Interventions

Non-surgical Interventions for the Liver

Non-surgical techniques are now available to treat abnormalities within the liver. These procedures are performed in the hospital in a radiology suite by an interventional radiologist.

Biliary Drainage – Biliary Stent – implanted drainage catheter

A biliary stent, or tube, is used when the the bile duct —the pathway that drains bile from the liver to the intestines — has become blocked or narrowed. A biliary stent is a palliative option for a patient with an advanced-stage, harmful obstruction of the bile duct. During the procedure, a tiny tube or metal framework known as a stent is inserted via a catheter to open the obstruction or narrowed area in the bile duct, allowing bile to flow into the small intestine to aid in digestion. Learn more about biliary drainage and the placement of a drainage tube.

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Cholecystostomy Drain – gallbladder drainage

In a procedure called a cholecystostomy, a drain is placed to drain the gall bladder. The procedure, first developed in the 1980’s, involves a percutaneous cut (small incision) and image guidance to guide a drainage catheter into the appropriate gallbladder tissue. This procedure is sometimes done when the outlet, or “neck” of the gallbladder is blocked by a tumor or gallstone. Learn more about cholecystostomy.

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Transjugular Intrahepatic Porto-systemic Shunt – TIPS or TIPSS procedure

A transjugular intrahepatic porto-systemic shunt, frequently called a TIPS or TIPSS procedure, is a tube (shunt) that is placed between the portal vein (which carries blood from the intestines to the liver), and the hepatic vein (which carries blood from the liver back to the heart). This procedure is performed primarily in patients with cirrhosis or those that have a blockage of blood flow passing through the liver from the portal vein to the hepatic vein.

The blockage may be caused by scar tissue or pressure in the portal vein. This is called portal hypertension. As a result of the increase in pressure, much of the flow of blood bypasses the liver. If these veins going to the other organs enlarge, they are referred to as varices. Varices that form in the stomach and esophagus may rupture and bleed. The TIPS procedure creates an artificial path for the blood and reduces the pressure in the portal vein, preventing varices from forming. Fluid buildup, called ascites, may also occur.

During the TIPS procedure, an interventional radiologist passes a catheter with a shunt down the jugular vein from the neck using X-ray guidance. The shunt then is inserted between the portal and hepatic veins within the liver and the catheter is withdrawn. Learn more about the TIPS procedure.

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Paracentesis – belly drainage

There are several reasons why fluid can build up in the belly. Blockage can result in increased pressure in the portal vein. Injuries as well as disease states can cause not only varices that cause bleeding into the esophagus but also a buildup of fluid in the peritoneal cavity (abdomen) called ascites. This fluid, a pale yellow fluid called serous fluid, can be both uncomfortable and painful.

If a shunt cannot be placed, the liquid can be drained in a procedure called paracentesis. Learn more about paracentesis.

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Tunneled Peritoneal Catheter Placement – implanted belly drainage catheter

Tunneled peritoneal catheter insertion is a treatment option for recurrent fluid in the abdomen called ascites. A tunneled peritoneal catheter placed to relieve belly fullness, pain, and breathing issues associated with ongoing serous fluid buildup. Learn more about tunneled peritoneal catheter placement.

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