Distal splenorenal shunt procedure

Distal splenorenal shunt procedure is a surgical procedure used to treat portal hypertension and its complications, particularly esophageal varices bleeding. The procedure involves creating a new pathway for blood flow to bypass the liver, reducing pressure in the portal vein and preventing bleeding in the esophagus and stomach.

History

The distal splenorenal shunt procedure was first described by Warren WD and colleagues in 1967. It was developed as a treatment for portal hypertension, a condition characterized by increased pressure in the portal vein, which can lead to life-threatening bleeding in the esophagus and stomach.

Procedure

The distal splenorenal shunt procedure involves the creation of a new pathway for blood flow from the spleen to the kidney, bypassing the liver. This is achieved by connecting the distal splenic vein to the left renal vein, which effectively diverts blood flow away from the liver and reduces pressure in the portal vein.

The procedure is performed under general anesthesia, and the patient is typically hospitalized for several days postoperatively for monitoring and recovery.

Indications

The distal splenorenal shunt procedure is indicated for patients with portal hypertension who have experienced recurrent bleeding from esophageal varices despite medical and endoscopic therapy. It may also be considered in patients with refractory ascites.

Complications

As with any surgical procedure, the distal splenorenal shunt procedure carries risks, including infection, bleeding, and complications related to anesthesia. Specific to this procedure, there is a risk of shunt thrombosis or shunt failure, which may require further intervention.

See also

• Portal hypertension
• Esophageal varices
• Ascites
• Liver cirrhosis