Distal Splenorenal Shunt
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Distal Splenorenal Shunt
In medicine, a distal splenorenal shunt procedure (DSRS), also splenorenal shunt procedure and Warren shunt, is a surgical procedure in which the distal splenic vein (a part of the portal venous system) is attached to the left renal vein (a part of the systemic venous system). It is used to treat portal hypertension and its main complication (esophageal varices). It was developed by W. Dean Warren. Splenopancreatic and gastric disconnection (SPGD) DSRS is typically done with splenopancreatic and gastric disconnection (ligation of the gastric veins and pancreatic veins (that drain into the portal vein) and complete detachment of the splenic vein from the portal venous system), as it improves the outcome. Comparison to TIPS Survival with a transjugular intrahepatic portosystemic shunt (TIPS) versus a DSRS is thought to be approximately similar, but still an area of intensive research. Both TIPS and DSRS lead to decreased rates of variceal bleed Esophageal varices are extre ...
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Medicine
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others. Medicine has been practiced since prehistoric times, and for most of this time it was an art (an area of skill and knowledge), frequently having connections to the religious and philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, o ...
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Portal Vein
The portal vein or hepatic portal vein (HPV) is a blood vessel that carries blood from the gastrointestinal tract, gallbladder, pancreas and spleen to the liver. This blood contains nutrients and toxins extracted from digested contents. Approximately 75% of total liver blood flow is through the portal vein, with the remainder coming from the hepatic artery proper. The blood leaves the liver to the heart in the hepatic veins. The portal vein is not a true vein, because it conducts blood to capillary beds in the liver and not directly to the heart. It is a major component of the hepatic portal system, one of only two portal venous systems in the body – with the hypophyseal portal system being the other. The portal vein is usually formed by the confluence of the superior mesenteric, splenic veins, inferior mesenteric, left, right gastric veins and the pancreatic vein. Conditions involving the portal vein cause considerable illness and death. An important example of such a condi ...
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Digestive System Surgery
Digestive system surgery, or gastrointestinal surgery, can be divided into upper GI surgery and lower GI surgery. Subtypes Upper gastrointestinal Upper gastrointestinal surgery, often referred to as upper GI surgery, refers to a practise of surgery that focuses on the upper parts of the gastrointestinal tract. There are many operations relevant to the upper gastrointestinal tract that are best done only by those who keep constant practise, owing to their complexity. Consequently, a general surgeon may specialise in 'upper GI' by attempting to maintain currency in those skills. Upper GI surgeons would have an interest in, and may exclusively perform, the following operations: * Pancreaticoduodenectomy * Esophagectomy * Liver resection Lower gastrointestinal Lower gastrointestinal surgery includes colorectal surgery as well as surgery of the small intestine. Academically, it refers to a sub-specialisation of medical practise whereby a general surgeon focuses on the lower gastro ...
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Cleveland Clinic
Cleveland Clinic is a nonprofit American academic medical center based in Cleveland, Ohio. Owned and operated by the Cleveland Clinic Foundation, an Ohio nonprofit corporation established in 1921, it runs a 170-acre (69 ha) campus in Cleveland, as well as 11 affiliated hospitals, 19 family health centers in Northeast Ohio, and hospitals in Florida and Nevada. International operations include the Cleveland Clinic Abu Dhabi hospital in the United Arab Emirates and Cleveland Clinic Canada, which has two executive health and sports medicine clinics in Toronto."Facts & Figures"
Cleveland Clinic.
Another hospital campus in the United Kingdom, Cleveland Clinic London, opened to outpatients in 2021 and is scheduled to fully open in 2022. Tomislav Mihaljevic is the president and CEO. Cleveland Cl ...
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Transjugular Intrahepatic Portosystemic Shunt
Transjugular intrahepatic portosystemic shunt (TIPS or TIPSS) is an artificial channel within the liver that establishes communication between the inflow portal vein and the outflow hepatic vein. It is used to treat portal hypertension (which is often due to liver cirrhosis) which frequently leads to intestinal bleeding, life-threatening esophageal bleeding (esophageal varices) and the buildup of fluid within the abdomen (ascites). An interventional radiologist creates the shunt using an image-guided endovascular (via the blood vessels) approach, with the jugular vein as the usual entry site. The procedure was first described by Josef Rösch in 1969 at Oregon Health and Science University. It was first used in a human patient by Dr. Ronald Colapinto, of the University of Toronto, in 1982, but did not become reproducibly successful until the development of endovascular stents in 1985. In 1988 the first successful TIPS was realized by M. Rössle, G.M. Richter, G. Nöldge and J. Pa ...
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Hepatic Encephalopathy
Hepatic encephalopathy (HE) is an altered level of consciousness as a result of liver failure. Its onset may be gradual or sudden. Other symptoms may include movement problems, changes in mood, or changes in personality. In the advanced stages it can result in a coma. Hepatic encephalopathy can occur in those with acute or chronic liver disease. Episodes can be triggered by infections, GI bleeding, constipation, electrolyte problems, or certain medications. The underlying mechanism is believed to involve the buildup of ammonia in the blood, a substance that is normally removed by the liver. The diagnosis is typically based on symptoms after ruling out other potential causes. It may be supported by blood ammonia levels, an electroencephalogram, or a CT scan of the brain. Hepatic encephalopathy is possibly reversible with treatment. This typically involves supportive care and addressing the triggers of the event. Lactulose is frequently used to decrease ammonia levels. Cert ...
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Variceal Bleed
Esophageal varices are extremely Vasodilation, dilated sub-mucosal veins in the lower third of the esophagus. They are most often a consequence of portal hypertension, commonly due to cirrhosis. People with esophageal varices have a strong tendency to develop severe bleeding which left untreated can be exsanguination, fatal. Esophageal varices are typically diagnosed through an esophagogastroduodenoscopy. Pathogenesis The upper two thirds of the esophagus are drained via the esophageal veins, which carry deoxygenated blood from the esophagus to the azygos vein, which in turn drains directly into the superior vena cava. These veins have no part in the development of esophageal varices. The lower one third of the esophagus is drained into the superficial veins lining the esophageal mucosa, which drain into the left gastric vein, which in turn drains directly into the portal vein. These superficial veins (normally only approximately 1 mm in diameter) become distended up to 1– ...
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Transjugular Intrahepatic Portosystemic Shunt
Transjugular intrahepatic portosystemic shunt (TIPS or TIPSS) is an artificial channel within the liver that establishes communication between the inflow portal vein and the outflow hepatic vein. It is used to treat portal hypertension (which is often due to liver cirrhosis) which frequently leads to intestinal bleeding, life-threatening esophageal bleeding (esophageal varices) and the buildup of fluid within the abdomen (ascites). An interventional radiologist creates the shunt using an image-guided endovascular (via the blood vessels) approach, with the jugular vein as the usual entry site. The procedure was first described by Josef Rösch in 1969 at Oregon Health and Science University. It was first used in a human patient by Dr. Ronald Colapinto, of the University of Toronto, in 1982, but did not become reproducibly successful until the development of endovascular stents in 1985. In 1988 the first successful TIPS was realized by M. Rössle, G.M. Richter, G. Nöldge and J. Pa ...
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Portal Venous System
In the circulatory system of animals, a portal venous system occurs when a capillary bed pools into another capillary bed through veins, without first going through the heart. Both capillary beds and the blood vessels that connect them are considered part of the portal venous system. They are relatively uncommon as the majority of capillary beds drain into veins which then drain into the heart, not into another capillary bed. Portal venous systems are considered venous because the blood vessels that join the two capillary beds are either veins or venules. Examples of such systems include the hepatic portal system, the hypophyseal portal system, and (in non-mammals) the renal portal system. Unqualified, ''portal venous system'' often refers to the hepatic portal system. For this reason, ''portal vein'' most commonly refers to the hepatic portal vein. The functional significance of such a system is that it transports products of one region directly to another region in relati ...
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Pancreatic Vein
In human anatomy, the pancreatic veins consist of several small blood vessels which drain the body and tail of the pancreas, and open into the trunk of the great pancreatic vein. References

Veins of the torso {{circulatory-stub ...
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List Of Surgical Procedures
Many surgical procedure names can be broken into parts to indicate the meaning. For example, in gastrectomy, "ectomy" is a suffix meaning the removal of a part of the body. "Gastro-" means stomach. Thus, ''gastrectomy'' refers to the surgical removal of the stomach (or sections thereof). "Otomy" means cutting into a part of the body; a ''gastrotomy'' would be cutting into, but not necessarily removing, the stomach. And also "pharyngo" means pharynx, "laryngo" means larynx, "esophag" means esophagus. Thus, "pharyngolaryngoesophagectomy" refers to the surgical removal of the three. The field of minimally invasive surgery has spawned another set of words, such as ''arthroscopic'' or ''laparoscopic'' surgery. These take the same form as above; an arthroscope is a device which allows the inside of the joint to be seen. List of common surgery terms Prefixes * ''mono-'' : one, from the Greek μόνος, ''monos'', "only, single" * ''angio-'' : related to a blood vessel, from the Gre ...
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Gastric Vein (other)
Gastric vein may refer to: * Left gastric vein * Right gastric vein * Short gastric veins {{disambig ...
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