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In medicine, a distal splenorenal shunt procedure (DSRS), also splenorenal shunt procedure and Warren shunt, [1] is a surgical procedure in which the distal splenic vein (a part of the portal venous system) is attached to the left renal vein (a part of the systemic venous system).
The channel for the shunt is next created by inflating an angioplasty balloon within the liver along the tract created by the needle. The shunt is completed by placing a special mesh tube known as a stent or endograft to maintain the tract between the higher-pressure portal vein and the lower-pressure hepatic vein. After the procedure ...
A portacaval anastomosis or portocaval anastomosis is a specific type of circulatory anastomosis that occurs between the veins of the portal circulation and the vena cava, thus forming one of the principal types of portasystemic anastomosis or portosystemic anastomosis, as it connects the portal circulation to the systemic circulation, providing an alternative pathway for the blood.
Balloon-occluded retrograde transvenous obliteration (BRTO) is an endovascular procedure used for the treatment of gastric varices.When performing the procedure, an interventional radiologist accesses blood vessels using a catheter, inflates a balloon (e.g. balloon occlusion) and injects a substance into the variceal blood vessels that causes blockage of those vessels.
Portal hypertension is defined as increased portal venous pressure, with a hepatic venous pressure gradient greater than 5 mmHg. [3] [4] Normal portal pressure is 1–4 mmHg; clinically insignificant portal hypertension is present at portal pressures 5–9 mmHg; clinically significant portal hypertension is present at portal pressures greater than 10 mmHg. [5]
A portosystemic shunt or portasystemic shunt (medical subject heading term; PSS), also known as a liver shunt, is a bypass of the liver by the body's circulatory system.It can be either a congenital (present at birth) or acquired condition and occurs in humans as well as in other species of animals.
The Pringle manoeuvre is more effective in preventing blood loss during liver surgery if central venous pressure is maintained at 5 mmHg or lower. This is due to the fact that Pringle manoeuver technique aims at controlling the blood inflow into the liver, having no effect on the outflow. [3]
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]