A distal splenorenal shunt (DSRS) is a type of surgery done to relieve extra pressure in the portal vein. The portal vein carries blood from your digestive organs to your liver.
During DSRS, the vein from your spleen is removed from the portal vein. The vein is then attached to the vein to your left kidney. This helps reduce blood flow through the portal vein.
The portal vein brings blood from the intestine, spleen, pancreas, and gallbladder to the liver. When blood flow is blocked, the pressure in this vein becomes too high. This is called portal hypertension. It often occurs due to liver damage caused by:
When blood can't flow normally through the portal vein, it takes another path. As a result, swollen blood vessels called varices form. They develop thin walls that can break and bleed.
You may have this surgery if imaging tests such as endoscopy or x-rays show that you have bleeding varices. DSRS surgery reduces pressure on the varices and helps control bleeding.
Risks for anesthesia and surgery in general are:
Risks of this surgery include:
Before the surgery, you may have certain tests:
Give your health care provider a list of all the medicines you take including prescription and over-the-counter, herbs, and supplements. Ask which ones you need to stop taking before the surgery, and which ones you should take the morning of the surgery.
Your provider will explain the procedure and tell you when to stop eating and drinking before the surgery.
Expect to stay 7 to 10 days in the hospital after surgery to recover.
When you wake up after the surgery you will have:
As you are able to eat and drink, you will be given liquids and food.
You may have an imaging test to see if the shunt is working.
You may meet with a dietitian, and learn how to eat a low-fat, low-salt diet.
After DSRS surgery, bleeding is controlled in most people with portal hypertension. The highest risk of bleeding again is in the first month after surgery.
Reviewed By: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.