What is Portal Hypertension?

Portal hypertension is a condition in which the normal blood flow through the liver is slowed or blocked due to underlying scarring of the liver tissue.  The scarring is most frequently caused by cirrhosis or hepatitis.  As this blood is slowed down, the pressure in the vein builds up, causing blood to find other routes back to the heart.  Unfortunately, these other routes may not be able to handle the increased blood flow, causing the blood vessels to break open and bleed.  This bleeding can occur in the esophagus or stomach (bleeding "varices").

How can a TIPS procedure treat this problem without surgery?

Drs. Dunfee and Kennedy are the experts in treating portal hypertension with their minimally invasive techniques.  Using fluoroscopy or continuous, low-dose X-ray for guidance, a small catheter is "threaded" through a small nick in the skin near the neck.   The catheter is guided into the liver where it creates a tunneled through the tissue into the portal vein.  The tunnel is held open by the insertion of a small metal cylinder, called a stent.  This allows some blood to bypass the "clogged" liver tissue and decrease the pressure in the vein (and decreasing the risk of bleeding.

Last year alone, our physicians performed more TIPS procedures than anywhere in Florida, and quite possibly, the United States.

What is the cause of jaundice and bile duct obstruction?

Bile is a thick fluid normally produced by the liver to help with digestion in the gut.  The bile travels through small ducts like branches of a tree into a trunk or common bile duct.  In some patients, such as those with liver cancer or individuals who have had an injury to the liver, the bile ducts become blocked and bile cannot drain from the liver.  Dr. Dunfee or Kennedy will place a catheter through the skin and into the bile ducts to drain the bile.  In some cases, a small metal cylinder, called a stent, is placed in the liver to hold the blocked area open.  A catheter may also be placed to drain bile in patients who have a hole in the bile ducts or as preparation for surgery on the bile ducts.

Information on liver cancer and treatment options is available in the liver cancer section of the SIR Web site.

Liver Disease