Perspectives in shunt surgery in portal hypertensive bleeders [a new technique]

ABSTRACT

This study is meant to evaluate the use of inferior mesenteric vein as a natural narrow lumen conduit in shunting procedures of splenectomised bleeders and as a modification of original distal spleno-renal shunt [DSRS] in non splenectomised patients [genuine bleeders]. Twenty patients with bleeding esophageal varices were included in this study Ten were splenectomised and ten were genuine hypertensive bleeders. The last group was admitted for warren shunt [distal spleno-renal shunt] and had been shifted to the new technique according to difficult operative situation. Follow up clinically, by duplex and endoscopically was showing encouraging results. Further future application and study will judge the validity of what we call the shunt of future viz. [the inferior mesentrico-renal shunt] The inferior mesenteric vein represents a natural conduit that already present in the field of operation of [DSRS] and can be used as an alternative in difficult cases meant for [DSRS] or for post- splenectomised bleeders as an alternative to H gortex graft