Health Encyclopedia

Search the Health Encyclopedia

Distal splenorenal shunt

Definition

A distal splenorenal shunt (DSRS) is a type of surgery done to relieve extra pressure in the portal vein. The portal vein carries blood from your digestive organs to your liver.

Alternative Names

DSRS; Distal splenorenal shunt procedure; Renal - splenic venous shunt; Warren shunt; Cirrhosis - distal splenorenal; Liver failure - distal splenorenal; Portal vein pressure - distal splenorenal shunt

Description

During DSRS, the vein from your spleen is removed from the portal vein. The vein is then attached to the vein to your left kidney. This helps reduce blood flow through the portal vein.

Why the Procedure Is Performed

The portal vein brings blood from the intestine, spleen, pancreas, and gallbladder to the liver. When blood flow is blocked, the pressure in this vein becomes too high. This is called portal hypertension. It often occurs due to liver damage caused by:

When blood can't flow normally through the portal vein, it takes another path. As a result, swollen blood vessels called varices form. The most important location for these is in the esophagus. They develop thin walls that can break and bleed into the esophagus and stomach.

You may have this surgery if imaging tests such as upper GI endoscopy or x-rays show that you have bleeding varices in the esophagus or stomach. DSRS surgery reduces pressure on the varices and helps control bleeding.

Risks

Risks for anesthesia and surgery in general are:

  • Allergic reactions to medicines or breathing problems
  • Bleeding, blood clots, or infection

Risks of this surgery include:

  • Buildup of fluid in the belly (ascites)
  • Repeat bleeding from the varices
  • Encephalopathy (loss of brain function because the liver is unable to remove toxins from the blood)

Before the Procedure

Before the surgery, you may have certain tests:

Give your health care provider a list of all the medicines you take including prescription and over-the-counter, herbs, and supplements. Ask which ones you need to stop taking before the surgery, and which ones you should take the morning of the surgery.

Your provider will explain the procedure and tell you when to stop eating and drinking before the surgery.

After the Procedure

Expect to stay 7 to 10 days in the hospital after surgery to recover.

When you wake up after the surgery you will have at least one or more of the following:

  • A tube in your vein (IV) that will carry fluid and medicine into your bloodstream
  • A catheter in your bladder to drain urine
  • An NG tube (nasogastric) that goes through your nose into your stomach to remove gas and fluids
  • A pump with a button you can press when you need pain medicine

As you are able to eat and drink, you will be given liquids and food.

You may have an imaging test to see if the shunt is working.

You may meet with a dietitian, and learn how to eat a low-fat, low-salt diet.

Outlook (Prognosis)

After DSRS surgery, bleeding is controlled in most people with portal hypertension. The highest risk of bleeding again is in the first month after surgery.

References

Dudeja V, Ferrantella A, Fong Y. The liver. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 54.

Weeks SR, Ottmann SE, Orloff MS. Portal hypertension: role of shunting procedures. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:387-389.

Review Date:8/22/2022
Reviewed By:Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

adam.com

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.

Health Outcome Data

No data available for this condition/procedure.

Health Encyclopedia

More Features