Lower portal press. Portal vein bypass is a means of treating high blood pressure in the portal vein system. This often happens b/c of cirrhosis of the liver. Portal vein hypertension can result in severe bleeding from the esophagus. Decreasing the pressure can treat this. It doesn't fix the liver failure historically this was a open surg procedure with significant risks. Often now this is done by radiology (tips).
TIPSS? Patients with refractory ascites (maximum diuretic doses not sufficient to control ascites or unacceptable adverse effects/complications with diuretic therapy) can be managed with large-volume paracentesis (lvp) and Albumin replacement or transjugular intrahepatic portosystemic shunt (tipss) placement. Although tipss has been shown to be more effective than lvp and alb. Gives more encephalopathy.