BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuPortacaval shuntingShunt - portacaval; Liver failure - portacaval shunt; Cirrhosis - portacaval shuntPortacaval shunting is a surgical treatment to create new connections between two blood vessels in your abdomen. It is used to treat people who have severe liver problems. Description Portacaval shunting is major surgery. It involves a large cut (incision) in the belly area (abdomen). The surgeon then makes a connection between the portal vein (which supplies most of the liver's blood) and the inferior vena cava (the vein that drains blood from most of the lower part of the body.)The new connection diverts blood flow away from the liver. This reduces blood pressure in the portal vein and decreases the risk for a tear (rupture) and bleeding from the veins in the esophagus and stomach. Why the Procedure Is Performed Normally, blood coming from your esophagus, stomach, and intestines first flows through the liver. When your liver is very damaged and there are blockages, blood cannot flow through it easily. This is called portal hypertension (increased pressure and backup of the portal vein.) The veins can then break open (rupture), causing serious bleeding.Common causes of portal hypertension are:Alcohol use causing scarring of the liver (cirrhosis) Alcohol useAlcohol use disorder is when your drinking causes serious problems in your life, yet you keep drinking. You may also need more and more alcohol to f...ImageRead Article Now Book Mark Article CirrhosisCirrhosis is scarring of the liver and poor liver function. It is the last stage of chronic liver disease.ImageRead Article Now Book Mark Article Blood clots in a vein that flows from the liver to the heart Blood clotsBlood clots are clumps that occur when blood hardens from a liquid to a solid. A blood clot that forms inside one of your veins or arteries is calle...ImageRead Article Now Book Mark Article Too much iron in the liver (hemochromatosis) Hepatitis B or hepatitis CHepatitis BHepatitis B is irritation and swelling (inflammation) of the liver due to infection with the hepatitis B virus (HBV). Other types of viral hepatitis ...ImageRead Article Now Book Mark Article Hepatitis CHepatitis C is a viral disease that leads to swelling (inflammation) of the liver. Other types of viral hepatitis include:Hepatitis AHepatitis BHepat...ImageRead Article Now Book Mark Article When portal hypertension occurs, you may have:Bleeding from veins of the stomach, esophagus, or intestines (variceal bleeding) Buildup of fluid in the belly (ascites) AscitesAscites is the build-up of fluid in the space between the lining of the abdomen and abdominal organs.ImageRead Article Now Book Mark Article Buildup of fluid in the chest (hydrothorax) Portacaval shunting diverts part of your blood flow from the liver. This improves blood flow in your stomach, esophagus, and intestines.Portacaval shunting is most often done when transjugular intrahepatic portosystemic shunting (TIPS) has not worked. TIPS is a much simpler and less invasive procedure.Transjugular intrahepatic portosystemic...Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure to create new connections between two blood vessels in your liver. You may need ...ImageRead Article Now Book Mark Article Risks Risks for anesthesia and surgery in general are:Allergy to medicines, problems breathing Bleeding, blood clots, or infection Risks for this surgery include:Liver failure Worsening of hepatic encephalopathy (a disorder that affects concentration, mental status, and memory -- may lead to coma) After the Procedure People with liver disease are at a much higher risk for complications after surgery.People with severe liver disease that is getting worse may need to be considered for liver transplant.Open ReferencesReferencesDudeja 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.Henderson JM, Rosemurgy AS, Pinson CW. Technique of portosystemic shunting: portocaval, distal splenorenal, mesocaval. In: Jarnagin WR, ed. Blumgart's Surgery of the Liver, Biliary Tract, and Pancreas. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 86.Shah VH, Kamath PS. Portal hypertension and variceal bleeding. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 92.AllVideoImagesTogHepatic venous circulation - illustration The portal vein drains blood from the intestine, stomach, spleen, pancreas, and gallbladder into the liver. The liver processes the nutrients in this blood and filters out toxic substances. The hepatic veins then carry the blood away from the liver and into the inferior vena cava, which leads to the right atrium, one of the four chambers of the heart.Hepatic venous circulationillustrationHepatic venous circulation - illustration The portal vein drains blood from the intestine, stomach, spleen, pancreas, and gallbladder into the liver. The liver processes the nutrients in this blood and filters out toxic substances. The hepatic veins then carry the blood away from the liver and into the inferior vena cava, which leads to the right atrium, one of the four chambers of the heart.Hepatic venous circulationillustrationRelated Information Transjugular intrahepatic portosystemic shunt (TIPS)(Surgery) Review Date: 1/15/2021 Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, 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. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- © 1997- All rights reserved. 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