Portal Vein Bypass

Overview :

A choice of portal vein bypasses is available. Portal vein bypass is usually performed as an emergency operation in a hospital under general anesthesia. The surgeon makes an abdominal incision and finds the portal vein. In portacaval shunting, blood from the portal vein is diverted into the inferior vena cava. This is the most common bypass. In splenorenal shunting, the splenic vein (a part of the portal vein), is connected to the renal vein. A mesocaval shunt connects the superior mesenteric vein (another part of the portal vein) to the inferior vena cava.

Portal pressure can also be reduced in a procedure called transvenous intrahepatic portosystemic shunt (TIPS). A catheter is threaded into the portal vein, and an expandable balloon or wire mesh is inserted to divert blood from the portal vein to the hepatic vein. The rate of serious complications in TIPS is only 1-2%. The operation cannot be performed at all hospitals, but is becoming the preferred treatment for reducing portal pressure.