BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuDistal splenorenal shuntDSRS; Distal splenorenal shunt procedure; Renal - splenic venous shunt; Warren shunt; Cirrhosis - distal splenorenal; Liver failure - distal splenorenal; Portal vein pressure - distal splenorenal shuntA 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. 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:Alcohol use Chronic viral hepatitis Chronic viral hepatitisHepatitis is swelling and inflammation of the liver.ImageRead Article Now Book Mark Article Blood clots Certain congenital disorders Primary biliary cirrhosis (liver scarring caused by blocked bile ducts)Primary biliary cirrhosisThe bile ducts are tubes that move bile from the liver to the small intestine. Bile is a substance that helps with digestion. All of the bile ducts...ImageRead Article Now Book Mark Article When blood can't flow normally through the portal vein, it takes another path. As a result, swollen blood vessels called varices form. They develop thin walls that can break and bleed.You may have this surgery if imaging tests such as endoscopy or x-rays show that you have bleeding varices. DSRS surgery reduces pressure on the varices and helps control bleeding.EndoscopyERCP is short for endoscopic retrograde cholangiopancreatography. It is a procedure that looks at the bile ducts. It is done through an endoscope. ...ImageRead Article Now Book Mark Article Risks Risks for anesthesia and surgery in general are: Allergic reactions to medicines or breathing problems Breathing problemsBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article Bleeding, blood clots, or infectionRisks 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) EncephalopathyLoss of brain function occurs when the liver is unable to remove toxins from the blood. This is called hepatic encephalopathy (HE). This problem ma...Read Article Now Book Mark Article Before the Procedure Before the surgery, you may have certain tests:Angiogram (to view inside the blood vessels) Blood tests EndoscopyEndoscopyEndoscopy is a way of looking inside the body using a flexible tube that has a small camera and light on the end of it. This instrument is called an...ImageRead Article Now Book Mark Article 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: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 medicineAs 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.Open ReferencesReferencesDudeja V, Fong Y. The liver. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 53.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.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 Review Date: 9/30/2020 Reviewed By: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. 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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