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A portacaval shunt is a major surgical procedure that is used to create a new connection between blood vessels in your liver. Your doctor will recommend this procedure if you are suffering from severe liver problems.
When you’re healthy, blood from your stomach, intestines, and esophagus flows through the liver. The portal vein (or "hepatic portal vein") carries blood from the digestive system to the liver.
However, if your liver is severely damaged, the blood will not flow through it at a healthy rate. This causes the blood to back up, increasing pressure at the portal vein. This causes a condition known as portal hypertension. There are a number of potential underlying causes of portal hypertension, including:
In turn, portal hypertension can lead to more serious health issues, including:
Portacaval shunting improves the flow of blood between your liver, esophagus, stomach, and intestines.
To determine if you have a liver disease and need a portacaval shunt, your doctor may recommend one or more of the following tests:
Possible symptoms of portal hypertension are:
You will be given general anesthetic so that you are asleep and do not feel any discomfort during this surgical procedure. Your surgeon will make a large incision in your abdomen, and will connect the portal vein (the short vein that supplies the liver with blood) to the inferior vena cava (the blood vessel that takes blood from the organs and lower limbs to the heart). By making this new connection, blood will bypass the liver and reduce the blood pressure in the liver.
This procedure has a number of benefits, including:
Though most healthy people do not have any problems with general anesthesia, there is a small risk of complications and, though rarely, death. These risks are largely dependent upon your general health and the type of procedure you are undergoing. Some factors may increase your risk of complications, such as:
If you have such medical complications or are elderly you may be more at risk of the following complications, though these are rare:
Anesthesia awareness is the unintended awakening or awareness of a patient during general anesthesia. This may happen if you have not been given enough general anesthesia. It is very rare, though—according to the Mayo Clinic, it only happens in one or two people out of every 1,000 (Mayo Clinic, 2010). Should this happen, you will wake very briefly and may be aware of your surroundings but will feel no discomfort.
On extremely rare occasions some people will experience severe pain, which can lead to chronic emotional and psychological problems. Factors that may increase the risk of anesthesia awareness include:
All forms of surgery carry some risks, including:
Potential complications specifically connected to a portacaval shunt include:
If you are suffering from liver disease (such as cirrhosis) you are at an increased risk of post-surgery complications. These include:
If you suffer from chronic progressive liver disease, your doctor may evaluate you for a liver transplant.
Written by: Corinna Underwood
Medically reviewed : George Krucik, MD
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