Cirrhosis: Surgical Shunts for Portal Hypertension

Cirrhosis: Surgical Shunts for Portal Hypertension

Surgery Overview

Shunt surgeries are designed to redirect the flow of blood or belly fluid through other areas of the body. Types of shunts used include:

Peritoneovenous shunts.

These shunts may reduce fluid buildup in the belly (ascites). They divert the fluid into normal blood circulation.

Portacaval shunts.

These shunts may lower blood pressure in the vein that carries blood to the liver (portal vein). They do this by diverting the flow of blood from the portal vein to the large vein that returns blood to the heart (vena cava).

Why It Is Done

Shunts are rarely used because of the complications they may cause. They are done only in medical centers where the surgeon is experienced in doing the procedures.

Shunt surgery may be used for people who:

  • Have relatively good liver function and serious complications of portal hypertension, especially recurrent bleeding from enlarged veins (variceal bleeding).
  • Are not good liver transplant candidates because of advanced age, continuing alcohol use, or both.
  • Have not had success with other treatments, such as variceal banding for bleeding or diuretics for ascites.
  • Have ascites and can't have a transjugular intrahepatic portosystemic shunt (TIPS) or repeated paracenteses.
  • Do not have close access to medical care and cannot quickly return for more variceal banding treatments or paracenteses.

Risks

Complications of shunt surgery may include changes in mental function (encephalopathy), such as confusion, memory loss, and irritability. People who have large-diameter portacaval shunts have a 30% to 40% rate of encephalopathy.footnote 1

Related Information

References

Citations

  1. Shah VH, Kamath PS (2010). Portal hypertension and gastrointestinal bleeding. In M Feldman et al., eds., Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 9th ed., vol. 2, pp. 1489–1516. Philadelphia: Saunders.

Credits

Current as of: October 28, 2020

Author: Healthwise Staff
Medical Review:
Adam Husney MD - Family Medicine
W. Thomas London MD - Hepatology

Disclaimer: The information contained in this website, and its associated websites, is provided as a benefit to the local community, and the Internet community in general; it does not constitute medical advice. We try to provide quality information, but we make no claims, promises or guarantees about the accuracy, completeness, or adequacy of the information contained in or linked to this website and its associated sites. As medical advice must be tailored to the specific circumstances of each patient and healthcare is constantly changing, nothing provided herein should be used as a substitute for the advice of a competent physician. Furthermore, in providing this service, Adventist HealthCare does not condone or support all of the content covered in this site. As an Adventist health care organization, Adventist HealthCare acts in accordance with the ethical and religious directives for Adventist health care services.

Find a Doctor

Find an Adventist HealthCare affiliated doctor by calling our FREE physician referral service at 800-642-0101 or by searching our online physician directory.

View Doctors

Set Your Location

Setting your location helps us to show you nearby providers and locations based on your healthcare needs.