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Retroperitoneal approach for portasystemic decompression.

R J Stoney, J T Mehigan, C Olcott

    Archives of Surgery (Chicago, Ill. : 1960)
    |November 11, 1975
    PubMed
    Summary
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    A novel retroperitoneal approach successfully created renal-splenic shunts for portal decompression in patients with variceal hemorrhage. This technique offers a safe alternative when transperitoneal shunts are contraindicated.

    Area of Science:

    • Surgical Innovation
    • Hepatobiliary Surgery
    • Vascular Surgery

    Background:

    • Massive variceal hemorrhage necessitates effective portal decompression.
    • Conventional transperitoneal portasystemic shunts may be contraindicated due to intra-abdominal findings.
    • Alternative surgical approaches are needed for complex cases.

    Observation:

    • A left retroperitoneal approach was developed for renal-splenic shunt creation.
    • Seven patients with massive variceal hemorrhage and contraindications for transperitoneal shunts were treated.
    • This approach successfully created shunts and achieved portal decompression in all cases.

    Findings:

    • The retroperitoneal approach successfully decompressed the portal system in all seven patients.
    • Portal decompression resulted in cessation of variceal bleeding in every instance.

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  • This technique effectively avoided potential complications associated with transperitoneal procedures.

    • Implications:

    • The retroperitoneal approach is a viable and safe alternative for portasystemic decompression.
    • It is particularly useful in patients where the peritoneal cavity must be avoided.
    • This surgical technique expands options for managing massive variceal hemorrhage.