Early experience with the selective splenocaval shunt for variceal bleeding

Area of Science:

• Vascular Surgery
• Gastroenterology
• Interventional Radiology

Background:

• Recurrent gastroesophageal varices necessitate surgical management, with selective variceal decompression being the preferred approach.
• The distal splenorenal shunt is a common method for selective decompression but has contraindications.
• Alternative surgical options are needed for patients unsuitable for the distal splenorenal shunt.

Purpose of the Study:

• To evaluate the efficacy and applicability of the splenocaval shunt as an alternative for selective variceal decompression.
• To assess the splenocaval shunt in patients with limitations for the distal splenorenal shunt.

Main Methods:

• Review of seven patients who underwent a selective splenocaval shunt procedure.
• Surgical construction involving direct anastomosis of the splenic vein to the infrarenal vena cava.

Main Results:

• The splenocaval shunt was successfully employed in patients with contraindications to the distal splenorenal shunt.
• Early experience suggests the feasibility of the splenocaval shunt in specific clinical scenarios.

Conclusions:

• The splenocaval shunt is a valuable alternative for selective variceal decompression.
• It provides a solution for managing recurrent gastroesophageal varices when the distal splenorenal shunt cannot be performed.