What is it?
The portal vein carries blood from the intestines and spleen to the liver. Shunt surgery connects the portal venous system to another, lower-pressure vein, redirecting blood flow and relieving the pressure that drives variceal bleeding.
Who is this for?
- Extrahepatic portal vein obstruction (EHPVO) in children
- Budd-Chiari syndrome
- Adults with cirrhosis-related portal hypertension
- Recurrent variceal bleeding not responding to endoscopic treatment
How is the procedure performed?
- Splenorenal (Warren) shunt connects the splenic vein to the kidney vein
- Mesocaval shunt connects the mesenteric vein to the vein returning blood to the heart
- Rex shunt used in children with EHPVO to restore near-normal liver blood flow
- Vascular anatomy mapped beforehand with CT or MR angiogram
What are the benefits?
Durable, long-term protection against future episodes of variceal bleeding.
Relieves dangerous pressure driving blood into fragile esophageal and stomach veins.
Preserves some blood flow to the liver, depending on the shunt selected.
Rex shunt restores near-normal circulation, supporting healthy liver growth in children.
Reduces reliance on repeated endoscopic banding or sclerotherapy sessions.
Tailored to each patient's anatomy, guided by detailed vascular imaging.
Effective alternative when endoscopic treatments have already failed.
Supports long-term wellbeing for both children and adults with portal hypertension.
What should patients expect (risks & recovery)?
Shunt surgery requires a detailed understanding of each patient's vascular anatomy, usually mapped in advance with specialized imaging such as a CT or MR angiogram, or occasionally direct venous pressure studies. The choice of shunt depends on which veins are open and usable, the underlying cause of the portal hypertension, and the patient's age and overall health. Because these are specialized procedures requiring particular surgical expertise, careful patient selection and pre-operative planning are essential to achieving safe, lasting results. Most patients experience durable, long-term protection against future bleeding episodes once the shunt has been established.
