A simplified method and approach to the distal splenorenal shunt

Several procedures have been developed to obtain decompression of protal hypertension for bleeding esophageal varices. In recent years, the distal splenorenal shunt has become popular becuase it causes less encephalopathy than the standard portacaval or mesocaval shunts. A criticism of the distal splenorenal shunt has been the technical difficulty of dissecting the splenic vein and obtaining adequate exposure. We have facilitated some of these difficulties by exposing a retroperitoneal approach and by the use of a Smith ring retractor.