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Updated: Jun 29, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Is There Still a Role for Surgical Shunts in the Treatment of Budd-Chiari Syndrome? A 25-Year Experience
Kursat Rahmi Serin1, Yaman Tekant2, Ali Emre2
1HPB Surgery Unit, Department of General Surgery,Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. krserin@istanbul.edu.tr.
Purpose:
To investigate the long-term results of shunt surgery in the treatment of Budd-Chiari Syndrome.
Methods:
Medical records of patients treated with Budd-Chiari Syndrome between 1993 and 2006 were reviewed.
Results:
Thirty-seven patients (26 female, 11 male) were identified, with a median age of 30 years (range 14-51). Median duration of symptoms was 3 months (range 1 month to 10 years). Twenty-five patients, all in acute or subacute stages of disease, were treated surgically. Constructed shunts were mesoatrial in 17, portocaval in five (one was converted from a failed portorenal shunt) and mesocaval in three. Median portal pressure decreased from 44 cm H2O (range 31-55) to 20 cm H2O (range 5-27). Seven patients (28%) died in the perioperative period. Eighteen patients (72%) were followed up for a median of 186 months (24-241 months). Seven patients died during follow-up, five due to reasons related to the underlying cause and treatment. Remaining 11 patients (61%) were alive at a median of 18 years (13-25 years) with patent shunts. One-, 5-, and 10-year survival rates in patients undergoing shunt surgery were 78%, 72%, and 66%, respectively.
Conclusion:
Portosystemic shunts may still be considered when expertise for transjugular intrahepatic portosystemic shunt or liver transplantation is not available.
