Shunt Surgery for portal HTN(open)

Shunt Surgery for portal HTN (open Surgery)
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Shunt Surgery for portal HTN(open)

What is Shunt Surgery for portal HTN (open Surgery)?

Shunt surgery is a surgical procedure performed to reduce high blood pressure in the portal vein system, known as portal hypertension. This condition often results from liver cirrhosis, portal vein thrombosis, or congenital disorders, leading to complications such as variceal bleeding, ascites, and hepatic encephalopathy. Open shunt surgery creates a new pathway for blood flow, bypassing the liver and reducing pressure in the portal system.

Shunt Surgery for portal HTN(open)

Indications for Shunt Surgery

  • Recurrent or uncontrolled variceal bleeding despite medical/endoscopic treatment

  • Severe ascites that does not respond to conventional therapy

  • Portal vein thrombosis leading to increased portal pressure

  • Prevention of life-threatening complications in patients with advanced liver disease

Types of Shunt Procedures

Portosystemic Shunts

  • Splenorenal Shunt – Connects the splenic vein to the renal vein to divert blood flow.

  • Mesocaval Shunt – Links the superior mesenteric vein to the inferior vena cava.

  • Portocaval Shunt – Directly connects the portal vein to the inferior vena cava.

Distal Splenorenal Shunt (Warren Shunt)

  • Selectively reduces pressure in esophageal varices while preserving liver perfusion.

Symptoms Indicating the Need for Shunt Surgery

  • Severe or recurrent gastrointestinal bleeding from esophageal or gastric varices

  • Persistent abdominal distension and ascites unresponsive to treatment

  • Hepatic encephalopathy due to blood bypassing liver detoxification

  • Reduced liver function leading to complications of portal hypertension

Diagnosis & Preoperative Evaluation

Dr. Vikram Lotwala utilizes advanced diagnostic techniques to evaluate patients for shunt surgery:

  • Doppler Ultrasound & CT Angiography – Assessing blood flow and identifying suitable vessels for shunt placement.

  • Endoscopy – To detect varices and bleeding risks.

  • Liver Function Tests & Coagulation Profile – Evaluating liver health and surgical risks.

  • Portal Pressure Measurement – To confirm the severity of portal hypertension.

Surgical Procedure

  • General anesthesia is administered.

  • A surgical incision is made to access the abdominal cavity.

  • The selected shunt is created to reroute blood flow and lower portal pressure.

  • Bleeding varices are addressed if necessary.

  • Postoperative monitoring ensures proper function and recovery.

Post-Surgical Care & Follow-Up

  • Hospital stay for monitoring and recovery.

  • Medications to prevent clot formation and manage liver function.

  • Regular imaging and lab tests to assess shunt function and complications.

  • Lifestyle modifications to support liver health and prevent recurrence.

Why Choose Dr. Vikram Lotwala?

Dr. Vikram Lotwala is a highly skilled surgeon specializing in hepatobiliary and portal hypertension surgeries. With a patient-centric approach and expertise in advanced surgical techniques, he ensures the best possible outcomes for patients requiring shunt surgery.

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    If you or a loved one is facing complications due to portal hypertension, consult Dr. Vikram Lotwala for expert evaluation and treatment options.