Distal splenorenal shunt

Patients with obvious portal hypertension, accompanied by extensive esophageal and gastric varicose veins, and severe or repeated major varicose vein rupture and major bleeding, can seek shunting treatment as soon as possible. The timing of surgery is very important. Avoid shunt surgery when acute bleeding occurs. Conservative treatment should be used to stop bleeding. The general situation improves. It is advisable to perform surgery when liver function is low or high (Table 1). Under 50 years old. There are many differences of opinion on preventive shunting, and the indications should be more cautious. At the same time as splenectomy, end-to-side anastomosis is performed using the proximal end of the spleen vein and the anterior wall of the left renal vein to allow high-pressure portal vein blood to flow into the low-pressure renal vein through the anastomosis to reduce blood pressure, and also solve the problem of hypersplenism . However, due to the small anastomosis, stenosis and thrombosis are prone to occur after surgery, and the incidence of hepatic encephalopathy is also high. In recent years, it has been gradually replaced by selective shunting.

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