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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As a result, swollen blood vessels called varices form. Upper digestive bleeding in cirrhosis. Subsequently, hepatosplenomegaly and portal hypertension complicated by esophageal variceal bleeding, ascites and hepatic coma indicate the end stage of liver disease[ 202223 ]. We believe that the simplified splenorenal shunt technique described here can eliminate all of these adverse postoperative consequences.

Thirty-day operative mortality and long-term survival rates were evaluated.

More recently, the development of transjugular intrahepatic portosystemic shunting TIPS has added substantially to the armamentarium of therapeutic options for patients with complications of chronic liver disease.

Rebleeding within first 5 days was regarded as treatment failure, while rebleeding up to 6 weeks considered as secondary prophylaxis failure[ ]. Footnotes Address for reprints: Distal splenorenal shunt procedures were developed to decompress the esophagogastric region selectively while preserving hepatic portal perfusion in the hope of decreasing the rate of encephalopathy.

Hepatitis C disease assumed increasing importance in later years and undoubtedly contributed to cirrhosis in patients with cryptogenic or alcoholic liver disease before serologic markers became routinely available.


Furthermore, other authors have revealed that the combination of beta-blockers and endoscopic band ligation is superior to banding ligation alone in prevention of variceal recurrence and refractory bleeding[ – ].

Large varices remain despite placement of multiple coils open arrow.

Why do I need to have the distal splenorenal shunt procedure? This is called portal hypertension.

Adult-to-adult living donor liver transplantation using extended right lobe grafts. In the conventional Linton’s shunt procedure, such a situation would require the interposition of a venous graft to create a splenorenal shunt.

Br Med J ;2: Semin Liver Dis ;6: When you wake up after the surgery you will have: All children were able to resume full activity including contact sports. We are grateful to Dr. Sometimes, a large number of cases with variceal bleeding cannot be a candidate for liver transplantation as an emergency procedure because of advanced age, non-compliance for immunosuppressive drugs, advanced comorbidities and long waiting list time related to donor graft shortage[, ].

Distal Splenorenal Shunt | Cleveland Clinic

Blood samples for baseline laboratory tests can be done upon initial presentation complete blood count; renal function test; liver function test; international normalized ratio.

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Digital subtraction angiography Cerebral angiography Aortography Fluorescein angiography Radionuclide angiography Magnetic resonance angiography. Patients in Group I underwent a splenorenal shunt by means of the conventional procedure, and patients in Group II underwent a splenorenal shunt with the simplified procedure.

Early liver dysfunction in schistosomiasis.

Distal splenorenal shunt procedure – Wikipedia

A trial to increase the donor pool by split livers, selected brain-stem death donors, and living donors[ ]. Spldnorenal medial stump of the splenic vein oversewed by running prolene.


Purchase access Subscribe now. Inside the human body, schistosomula, enter the vasculature of the host, then migrate to the lungs and remain there for several days before travelling to the liver.

The 1- and 5-year survival rates were Hemostatic dysfunction is increased in patients with hepatosplenic schistosomiasis mansoni and advanced periportal fibrosis. Bladder cancer Al-Ahram Press; Therefore, any treatment option to control variceal hemorrhage should reduce the incidence of bleeding, maintain hepatic reserve, and remain durable for years.

When blood can’t flow normally through the portal vein, it takes another path. Assessment of variceal pressure by continuous non-invasive endoscopic registration: The primary indication for DSRS was recurrent variceal bleeding. This article has been cited by other articles in PMC.

Distal Splenorenal Shunt

Endoscopic band ligation is preferable to endoscopic sclerotherapy by reducing recurrent variceal bleeding risk and variceal stricture incidence in poor intolerance or beta-blocker therapy contraindications[ – ].

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. Digestive system surgery General surgery Vascular surgery.

The oesophagogastroduodenoscopy OGD can demonstrate esophagogastric varices [Figure 4]. Why portal hypertensive varices bleed and bleed:

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