Distal splenorenal shunt procedure
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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). It is used to treat portal hypertension and its main complication (esophageal varices).[1]
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Splenopancreatic and gastric disconnection (SPGD)
DSRS is typically done with splenopancreatic and gastric disconnection (ligation of the gastric veins and pancreatic veins (that drain into the portal vein) and complete detachment of the splenic vein from the portal venous system), as it improves the outcome.[1]
Comparison to TIPS
Survival with a transjugular intrahepatic portosystemic shunt (TIPS) versus a DSRS is thought to be approximately similar,[1][1] but still an area of intensive research.[1]
Both TIPS and DSRS lead to decreased rates of variceal bleeding at the expense of hepatic encephalopathy; however, TIPS appears to have more shunt dysfunction and lead to more encephalopathy and bleeds.[1] DSRS appears to be more cost effective than TIPS.[1]
References
External links
- Distal Splenorenal Shunt Procedure (Cleveland Clinic) - has some schematics that show what is done in the procedure.
- Portal Hypertension (Mohawk Valley Vascular Center) - has some schematics that show what is done in the procedure.
Health Science – Medicine - Surgery - Vascular surgery procedures | |
|---|---|
| Aortic aneurysm / dissection | Open AAA repair - Endoluminal AAA repair (EVAR) |
| Carotid stenosis | Carotid endarterectomy - Carotid stenting |
| Varicose veins | Ambulatory phlebectomy - Laser ablation - Sclerotherapy - Vein stripping |
| Peripheral arterial occlusive disease | Angioplasty with/out Stenting - Balloon embolectomy - Peripheral arterial bypass surgery - Thrombectomy |
| Liver cirrhosis | Transjugular intrahepatic portosystemic shunt (TIPS) - Distal splenorenal shunt procedure |
| Other vascular procedures | Venous cutdown - Cardiopulmonary bypass - Cardioplegia - Extracorporeal membrane oxygenation |
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