The DSRS is a surgical procedure during which the vein from the spleen (called the splenic vein) is detached from the portal vein and attached to the left kidney (renal) vein. This surgery selectively reduces the pressure in the varices and controls the bleeding associated with portal hypertension. It is usually performed only in patients with good liver function.
A general anesthetic is given before the surgery, which lasts about four hours. You should expect to stay in the hospital from seven to 10 days.
How Successful Is the DSRS Surgery?
DSRS controls bleeding in more than 90% of patients, with the highest risk of any re-bleeding occurring in the first month. The DSRS procedure provides good long-term control of bleeding in those with portal hypertension.
What Complications Are Associated With DSRS Surgery?
Ascites, an accumulation of fluid in the abdomen, can occur with DSRS surgery. This can be treated with diuretics and restricted sodium intake
Follow-Up Care Following TIPS or DSRS Procedures
Follow-up care for TIPS and DSRS can differ depending on where the procedures are performed. Below find basic guidelines.
Ten days after hospital discharge, meet with your surgeon or hepatologist (liver specialist) to evaluate your progress. Lab work will be done at this time.
Six weeks after the TIPS procedure (and again three months after the procedure), have an ultrasound so your doctor can check that the shunt is functioning properly. You will have an angiogram (an x-ray of blood vessels) only if the ultrasound indicates that there is a problem. You will also have lab work done at these times.
Six weeks after the DSRS procedure (and again three months after the procedure), meet with the surgeon to evaluate your progress. Lab work will be done at this time.
Six months after either the TIPS or DSRS procedure, have an ultrasound to make sure the shunt is working properly. Also, visit the surgeon or hepatologist.
Twelve months after either procedure, have another ultrasound of the shunt. Also, you may have an angiogram so that your doctor can check the pressure within your veins across the shunt.
If the shunt is working well, every six months after the first year of follow-up appointments, have an ultrasound, lab work, and visit with your doctor.
More frequent follow-up visits may be necessary, depending on your condition.
Attend all follow-up appointments as scheduled to ensure that the shunt is functioning properly. Be sure to follow the dietary recommendations that your healthcare providers give you.
Hemorrhoid is an enlarged vein in the walls of the anus and sometimes around the
rectum, usually caused by untreated constipation, but occasionally associated
with chronic diarrhea. If untreated, hemorrhoids can
worsen, protruding from the anus. Also known as piles.
Cirrhosis of the liver refers to a disease in which normal liver cells are replaced by scar tissue caused by alcohol and viral hepatitis B and C. This disease leads to abnormalities in the liver's ability to handle toxins and blood flow, causing internal bleeding, kidney failure, mental confusion, coma, body fluid accumulation, and frequent infections. Symptoms include yellowing of the skin, itching, and fatigue.
Liver disease can be cause by a variety of things including infection (hepatitis), diseases such as gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause; however, common symptoms may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
Ascites, the accumulation of fluid in the abdominal cavity is most commonly caused by cirrhosis of the liver. Some of the other causes of ascites include portal hypertension, congestive heart failure, blood clots, and pancreatitis. The most common symptoms include increased abdominal girth and size, abdominal bloating, and abdominal pain. Treatment depends on the cause of ascites.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Choledochal cysts are cysts of the bile ducts. There are several different types of choledochal cysts. These cysts are congenital, however, their cause is not known. Symptoms of choledochal cysts in infants include an enlarged liver and jaundice. In older people, the cysts cause abdominal pain, jaundice, cholangitis, gallstones, and pancreatitis. Treatment for choledochal cysts is surgery.
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