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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Terlipressin therapy with and without albumin for patients with hepatorenal syndrome: Create a free personal account to download free article PDFs, sign up for alerts, and more. The leading cause of death is recurrent variceal bleeding associated with a preserved liver function. The relationship between uncomplicated schistosomiasis and hepatitis B infection. We present the surgical details and results of 20 splenorenal anastomosis procedures performed within a period of 30 months.

Author information Copyright and License information Disclaimer. No patient died after either operation. Semin Liver Dis ;6: Selective shunt in the management of variceal bleeding in the era of liver transplantation.

The platelet count improved significantly in all seven children with presinusoidal portal hypertension or stable cirrhosis but did not increase in the child with hepatitis B and Child’s class B cirrhosis. Patients live in some geographic locations who cannot return back for multiple visits of endoscopy or TIPS[ ].

Therapy for portal hypertension is chosen on the basis of a complete evaluation, with an emphasis on hepatic function. The oesophagogastroduodenoscopy OGD can demonstrate esophagogastric varices [Figure 4].

Distal splenorenal shunt procedure – Wikipedia

Semin Liver Dis ; Most of the eggs carried upstream via the portal veins to the liver and trapped in the pre-sinusoidal portal venules[ 21 ]. By using this site, you agree to the Terms of Use and Privacy Policy.


Hemodynamic effects of acute changes in intra-abdominal pressure in patients splenorenzl cirrhosis. However, the mean duration of surgery and splenorena mean intraoperative blood loss were significantly less for patients in Group II than for those in Group I.

Endovascular aneurysm repair Open aortic surgery. Patients were selected for transplantation based on the development of end-stage liver failure in accordance to guidelines promulgated by the United Network for Organ Sharing. A distal splenorenal shunt is a surgical procedure.

Endoscopic ligation compared with sclerotherapy for treatment of esophageal variceal bleeding. Then one year later in Cambridge Calne et al. Transjugular intrahepatic portosystemic shunt versus H-graft portacaval shunt in the management of bleeding varices: This simplified Linton’s shunt facilitates the construction dlstal a trouble-free and tension-free splenorenal anastomosis.

Ann Trop Med Parasitol ; Long-term results of esophagogastric devascularization and splenectomy associated with endoscopic treatment in schistosomal portal hypertension. The primary indication for DSRS was recurrent variceal bleeding.

The sufficient length of splenic vein disconnected from pancreas and moves down to the left renal vein. Clinical Details of the 2 Groups of Patients.

Distal Splenorenal Shunt | Cleveland Clinic

Spatial distribution of schistosomiasis and treatment needs in sub-Saharan Africa: Privacy Policy Terms of Use. Appraisal of distal splenorenal shunt in the treatment of esophageal varices: The variceal rebleeding risk is highest within the first 6 weeks with a peak in the first 5 days[ 1 ]. Nat Rev Microbiol ;2: Then, through an interruption of the gastroepiploic arcade from the pylorus to the first short gastric vein and the lesser sac was opened to expose the pancreas [Figure 8].


Anti-inflammatory drugs and variceal bleeding: Although the end-stage liver failure was rarely seen in schistosomal patients, the deterioration diatal hepatic reserve has been expected following massive variceal bleeding with developed ascites and the splenic size regression[].

Distal splenorenal shunt

Some authors have revealed that praziquantel decrease or reverse sonographically periportal fibrosis by parasitic load reduction aimed to primary prophylaxis against a first variceal bleeding in the significant number of schistosomal cases[ 67 – 69 ]. Surgical treatments of refractory variceal bleeding According to the Baveno V consensus, refractory variceal bleeding was defined as a single episode of clinically significant rebleeding from portal hypertensive sources recurrent melena, hematemesis resulting in hospital admission, multiple blood transfusion and drop in hemoglobin up to three grams below normal level.

Then, holding the pancreas by its tail, along with the bundle of vessels didtal to it, we dissect the fusion fascia of Toldt from the tail to the middle of the body of the pancreas Fig.

Conflicts of interest There are no conflicts splenorebal interest. J Clin Pathol ; In patients with schistosomiasis alone the liver cirrhosis is rare but if co-infected with hepatitis B or C virus, progression to cirrhosis is brisk and this is common in endemic regions like Egypt and the Middle East[ 202534 – 38 ]. It complicated by thrombosis, stenosis and encephalopathy through portal flow diversion from the liver.