Portal vein bypass surgery


Portal vein bypass surgery is a type of surgery performed to divert blood from the portal vein into another vein.

June 4, 2022

Portal vein bypass surgery is a type of surgery performed to divert blood from the portal vein into another vein.

Some facts about Portal vein bypass surgery:

  • Portal vein bypass surgery is done when there is internal bleeding from blood vessels in the esophagus due to high pressure in the portal vein.
  • The portal vein is a major vein that splits into many branches that carries blood from the stomach and abdominal organs to the liver.
  • A chronic degenerative liver disease occurs in people with liver failure and cirrhosis. This causes irreversible scarring of the liver, in which the liver is incapable of processing blood from the bowels.
  • Blood will be drained from the bowels as a result of abnormally high pressure as the body tries to form other channels for the blood to empty into the main circulation.
  • Massive amounts of bleeding can result because of the fragility of fragile veins that surround the esophagus, stomach, or other areas of the digestive tract.
  • Portal hypertension, can also result in ascites.
  • So, portal vein bypass surgery can be done to lower portal hypertension by shunting blood away from the portal venous system and into the main venous system.

Preparation for Portal vein bypass surgery:

  • Quit smoking a few weeks before the surgery, make sure all other health conditions are well-managed before surgery, inform your doctor about any other supplements, prescriptions, and over-the-counter medications you are taking and about any possibility of pregnancy, if it is a scheduled surgery.
  • Any history of bleeding disorders or are taking any blood-thinning (anticoagulant) medicines, aspirin, or other medicines that affect blood clotting should be informed to your healthcare provider as you may need to stop taking these medicines before your surgery.
  • Take your medicine with a small sip of water to avoid drinking too much liquid if you do have to take any medications
  • Medical history, physical examination, blood test, and liver imaging studies using computed tomagraphy (CT) scans, ultrasounds, or magnetic resonance imaging (MRI) scans will be performed before surgery.
  • Standard preoperative blood and urine tests will be performed. 
  • The heart as well as arterial blood pressure are monitored both during and after the operation

Procedure for Portal vein bypass surgery:

  • Portal vein bypass surgery is usually performed under general anesthesia.
  • An abdominal incision will be made by the surgeon and the portal vein will be located.
  • Blood from the portal vein is diverted into the inferior vena cava which is one of the main veins leading back to the heart in portacaval shunting.
  • Portacaval shunting is the most common type of bypass surgery.
  • The splenic vein which is a part of the portal vein is connected to the renal vein in splenorenal shunting.
  • The superior mesenteric vein which is another part of the portal vein is connected to the inferior vena cava through a mesocaval shunt.
  • Tranjugular intrahe-patic portosystemic shunt (TIPS) is another procedure that can be done for Portal vein bypass surgery.
  • The patient will be connected to a heart monitor and fed through a nasogastric tube. 
  • Vital functions of the patient will be monitored through blood and urine tests.
  • Pain medication and antibiotics will be given.