Which of the following is a major complication the patient should be informed of before undergoing a transjugular intrahepatic portosystemic shunt (TIPS) procedure?

The major complication that patients should be informed of before undergoing a transjugular intrahepatic portosystemic shunt (TIPS) procedure is related to the potential for damage to surrounding structures during the puncture and placement of the shunt. Specifically, gallbladder puncture can occur due to the proximity of the gallbladder to the intended pathway of the shunt. This is particularly important in TIPS procedures, as the access point typically involves navigating through the liver, and understanding the risks of inadvertently puncturing adjacent organs is essential for informed consent.

While fever, malaise, and rosacea can be symptoms or side effects related to other medical conditions or procedures, they are not considered major complications specific to the TIPS procedure itself. Fever can occur post-procedure due to infection, malaise may indicate general discomfort or stress from the procedure, and rosacea is a dermatological condition unrelated to the risks or outcomes of performing a TIPS procedure. Hence, gallbladder puncture stands out as a significant complication that requires careful consideration and discussion with the patient prior to the procedure.