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A TIPS procedure decreases the effective vascular resistance of the liver through the creation of an alternative pathway for portal venous circulation. By creating a shunt from the portal vein to the hepatic vein, this intervention allows portal blood an alternative avenue for draining into systemic circulation.
In peptide synthesis, TIPS is used as a scavenger for peptide groups being removed from the peptide sequence at the global deprotection. TIPS is able to scavenge carbocations formed in the deprotection of a peptide as it can act as a hydride donor in acidic conditions. [1] Silanes may be preferred as scavengers in place of sulfur-based scavengers.
Hepatic encephalopathy type B may arise in those who have undergone a TIPS procedure; in most cases this resolves spontaneously or with the medical treatments discussed below, but in a small proportion of about 5%, occlusion of the shunt is required to address the symptoms.
Both TIPS and portacaval shunting effectively reduce portal pressure but share the risk of hepatic encephalopathy (HE) due to bypassing the liver's detoxification process. In TIPS, HE symptoms can often be managed by adjusting the stent, whereas portacaval shunting provides a permanent solution without the ability to make such adjustments.
TIPS, shown in progress here, has been shown to improve kidney function in individuals with HRS if portal pressures decrease after the procedure. A transjugular intrahepatic portosystemic shunt (TIPS) involves the decompression of the high pressures in the portal circulation by placing a small stent between a portal and hepatic vein.
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Procedure [ edit ] The surgery involves exposing the porta hepatis (the area of the liver from which bile should drain) by radical excision of all bile duct tissue up to the liver capsule and attaching a Roux-en-Y loop of jejunum to the exposed liver capsule above the bifurcation of the portal vein creating a portoenterostomy. [ 1 ]
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