Surgical outcomes of distal splenorenal shunt or liver transplantation in treatment of schistosomal refractory variceal bleeding. Wael Mohialddin Ahmed Doush1. the distal splenorenal shunt (dsrs) is a surgical procedure during which the vein from the spleen (called the splenic vein) is detached from the portal vein and. the distal splenorenal shunt (dsrs) procedure provides good long-term control of bleeding in many people with portal hypertension. dsrs controls bleeding in.

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Venous cutdown Arteriotomy Phlebotomy. The division of splenic vein between two vascular clamps leaving sufficient medial stump.

Although recanalization of the portal vein may occur during several months, complete or dkstal thrombosis of the portal vein adds complexity to a subsequent liver transplantation. Variceal ligation plus nadolol compared with ligation for prophylaxis of variceal rebleeding: Prevention of recurrent bleeding: Pharmacological treatment of portal hypertension: Liver disease in Egypt: Digital subtraction angiography Cerebral angiography Aortography Fluorescein angiography Radionuclide angiography Magnetic resonance angiography.

Distal splenorenal shunt

Surg Gynecol Obstet ; Give your health care provider a list of all the medicines you take prescription and over-the-counterherbs, and supplements. Dig Dis Sci ; Well-developed venous collaterals in the falciform ligament must be securely controlled with an assessment of the liver morphology distall gallbladder size[ ].

Pages with login required references or sources. Failing of vasoactive drug and endoscopic treatment combination, need initially balloon tamponade followed by repeat endoscopic therapy.


Although splenectomy can reverse the thrombocytopenia, the procedure should be avoided in children. Complete vascular control eistal the splenic vein is an important advantage of this simplified technique. Sudan Medical Monitor ;3: According to the classification system developed by Child, 8 patients in Group I had class A liver disease and 2 patients had class B disease. Sometimes called Bilharziasis or snail fever referred to Theodor Bilharz, a German surgeon working at Cairo Medical School who discovered the fluke in within the mesenteric veins of an Egyptian boy at autopsy [Figure 1].

The backup of pressure also causes the spleen to become enlarged. This article has been cited by other articles in PMC. Once an optimal length of splenic vein has dietal obtained, an end-to-side splenorenal anastomosis is performed.

Curr Treat Options Gastroenterol ; Long-term results of esophagogastric devascularization and splenectomy associated with endoscopic treatment in schistosomal portal hypertension.

Distal splenorenal shunt: MedlinePlus Medical Encyclopedia

Physical exercise increases portal pressure in patients with cirrhosis and portal hypertension. Injection sclerotherapy preceded by esophageal tamponade versus immediate sclerotherapy in dietal active variceal bleeding: Furthermore, another study was showed the use of terlipressin improves outcomes following acute variceal bleeding[ 93 ].

Upper digestive bleeding in cirrhosis. They develop thin walls that can break and bleed. The natural history of bleeding oesophageal varices in patients with schistosomal portal hypertension. Emergency sclerotherapy versus vasoactive drugs for variceal bleeding in cirrhosis: Liver transplantation in man-II, a report of two orthotopic liver transplants in adult recipients.

Prevalence of pulmonary hypertension in patients with hepatosplenic Mansonic schistosomiasis-prospective study. Semin Liver Dis ;6: Selective distal splenorenal shunt: Most complications developed during the perioperative phase and required observation or short-term treatment.


Distal splenorenal shunting was performed only in patients with Child A or B classification. Before diagnostic endoscopy intravenous vasoactive therapy must start urgently with 2 mg every 4 h for the first 48 h and maintained for 5 days using 1 mg of terlipressin every 4 h to prevent rebleeding or somatostatin mg bolus dose followed by mg infused hourly as the second choice for 5 days.

The vein from the spleen is disconnected from the portal vein and reconnected to the top of the left renal vein. Cleveland Clinic is a non-profit academic medical center.

Distal splenorenal shunt procedure

Surg Gynecol Obstet ; Your physician has chosen the distal splenorenal shunt procedure to treat this condition. On the other hand, the hepatic living donor grafts have three distinct advantages when dixtal with deceased donor grafts including of better graft function, shorter cold-ischemia time and help in early transplantation [ Figures 21 and 22 ] [ ].

Postoperative infection is another risk factor which decreased by giving the first dose of cephalosporin one hour before DSRS surgery and continued for 48 h after the operation.

Furthermore, these laboratory data are independently correlated with the presence of large esophageal varices or combined in the Child-Pugh score. The highest risk of bleeding again is in the first month after surgery.