Shunt Surgery in Kanpur

Advanced Shunt Surgery by an Experienced Gastro & GI Surgeon

Portal hypertension is a serious condition in which the pressure within the portal vein becomes abnormally high, most commonly due to chronic liver disease, portal vein thrombosis, or other vascular disorders. Increased portal pressure can lead to complications such as recurrent bleeding from esophageal or gastric varices, enlarged spleen, fluid accumulation in the abdomen (ascites), and reduced quality of life.

When medications and endoscopic treatments are insufficient or unsuitable, shunt surgery can help redirect blood flow, reduce portal pressure, and prevent life-threatening complications. At our center, we offer advanced shunt surgery tailored to each patient’s condition using evidence-based surgical techniques with a focus on safety, durable results, and faster recovery.

When is Shunt Surgery Recommended?

Shunt surgery may be recommended if you have:

Common Symptoms

You may need medical evaluation if you experience:

Vomiting blood (hematemesis)

Black, tarry stools (melena)

Enlarged spleen

Abdominal swelling due to ascites

Low blood cell counts due to hypersplenism

Fatigue and weakness

Recurrent gastrointestinal bleeding

Persistent abdominal discomfort

Loss of appetite

Our Approach to Shunt Surgery

Our experienced Gastro & GI Surgeon performs a detailed evaluation using blood tests, Doppler ultrasound, CT angiography, MRI, and endoscopy to determine the cause and severity of portal hypertension. After a comprehensive assessment, the most appropriate shunt procedure is selected based on the patient’s anatomy, liver function, age, and overall health. Our goal is to reduce portal pressure, prevent recurrent bleeding, preserve liver function whenever possible, and improve long-term outcomes.

Conditions We Treat

Portocaval Shunt

What is a Portocaval Shunt?

A Portocaval Shunt is a surgical procedure that connects the portal vein to the inferior vena cava, allowing blood to bypass the high-pressure portal circulation. This reduces portal hypertension and lowers the risk of recurrent variceal bleeding in selected patients.

Symptoms

Patients may have:

  • Recurrent vomiting of blood
  • Portal hypertension
  • Enlarged spleen
  • Ascites
  • Fatigue due to chronic liver disease
  • Recurrent gastrointestinal bleeding

When is Surgery Recommended?

Surgery may be advised if:

  • Variceal bleeding continues despite treatment.
  • Portal hypertension is severe.
  • Endoscopic therapy has failed.
  • The patient is a suitable candidate for surgical shunting.

Surgical Treatment

Treatment includes:

  • Portocaval Shunt Surgery
  • Comprehensive vascular evaluation
  • Pre-operative imaging and planning
  • Post-operative monitoring and long-term follow-up

Benefits

  • Reduces portal vein pressure
  • Prevents recurrent variceal bleeding
  • Improves blood flow
  • Reduces portal hypertension complications
  • Improves quality of life

Distal Splenorenal Shunt

What is a Distal Splenorenal Shunt?

Distal Splenorenal Shunt (DSRS) is a selective shunt procedure that connects the splenic vein to the left renal vein. It helps reduce pressure in esophageal varices while preserving blood flow through the liver, making it an effective option for selected patients with portal hypertension.

Symptoms

Patients may experience:

  • Recurrent upper gastrointestinal bleeding
  • Enlarged spleen
  • Low platelet count
  • Portal hypertension
  • Esophageal varices
  • Weakness and fatigue

When is Surgery Recommended?

DSRS may be recommended if:

  • Recurrent variceal bleeding occurs.
  • Liver function is relatively preserved.
  • Selective portal decompression is preferred.
  • The patient is suitable for elective surgery.

Surgical Treatment

Treatment includes:

  • Distal Splenorenal Shunt Surgery
  • Detailed vascular assessment
  • Advanced surgical reconstruction
  • Regular post-operative monitoring

Benefits

  • Effective control of variceal bleeding
  • Preserves portal blood flow to the liver
  • Reduces portal pressure
  • Lower risk of recurrent bleeding
  • Long-term symptom relief

Mesocaval Shunt

What is a Mesocaval Shunt?

A Mesocaval Shunt is a surgical procedure that connects the superior mesenteric vein to the inferior vena cava using a vascular graft. It diverts blood away from the high-pressure portal system and is considered in selected patients with portal hypertension when other treatment options are not suitable.

Symptoms

Patients may have:

  • Recurrent variceal bleeding
  • Severe portal hypertension
  • Enlarged spleen
  • Ascites
  • Portal vein obstruction
  • Recurrent gastrointestinal bleeding

When is Surgery Recommended?

Surgery may be advised if:

  • Other shunt procedures are unsuitable.
  • Portal hypertension remains uncontrolled.
  • The patient’s vascular anatomy favors mesocaval shunting.
  • Conservative treatment has failed.

Surgical Treatment

Treatment options include:

  • Mesocaval Shunt Surgery
  • Vascular graft placement
  • Comprehensive imaging evaluation
  • Long-term surveillance after surgery

Benefits

  • Decreases portal pressure
  • Reduces recurrent bleeding
  • Improves portal circulation
  • Effective treatment for selected patients
  • Long-term symptom control

Rex Shunt Procedure (Pediatric)

What is the Rex Shunt Procedure?

The Rex Shunt Procedure is a specialized pediatric operation performed primarily for children with extrahepatic portal vein obstruction. The procedure restores normal blood flow to the liver by creating a bypass using the patient’s own vein, helping relieve portal hypertension while preserving liver function.

Symptoms

Children may present with:

  • Recurrent vomiting of blood
  • Enlarged spleen
  • Low platelet count
  • Poor growth
  • Portal hypertension
  • Recurrent gastrointestinal bleeding

When is Surgery Recommended?

The Rex Shunt may be recommended if:

  • Extrahepatic portal vein obstruction is confirmed.
  • The child has recurrent variceal bleeding.
  • Liver function is preserved.
  • Imaging confirms suitable vascular anatomy.

Surgical Treatment

Treatment includes:

  • Rex Shunt Reconstruction
  • Pediatric vascular surgery
  • Detailed pre-operative imaging
  • Long-term follow-up and monitoring

Benefits

  • Restores normal portal blood flow
  • Reduces portal hypertension
  • Prevents recurrent bleeding
  • Preserves liver function
  • Supports healthy growth and development

Why Choose Dr. Puneet Puri for Shunt Surgery?

Experienced Gastrointestinal & Hepatobiliary Surgeon

Expertise in portal hypertension and complex vascular procedures

Advanced surgical planning with modern imaging

Personalized treatment for adults and pediatric patients

Evidence-based management of portal hypertension

Comprehensive pre-operative assessment

Enhanced Recovery After Surgery (ERAS) protocols

Focus on patient safety, reduced complications, and long-term outcomes

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Frequently Asked Questions About Shunt Surgery

Shunt surgery reduces high pressure in the portal venous system by creating an alternate pathway for blood flow. This helps prevent recurrent variceal bleeding and other complications of portal hypertension.

No. Treatment depends on the underlying cause, liver function, severity of portal hypertension, and response to medications or endoscopic therapy. Your surgeon will determine whether shunt surgery is the most appropriate option.

Recovery varies depending on the type of procedure and the patient’s overall health. Most patients require several days of hospitalization, followed by regular follow-up to monitor recovery and shunt function.

Yes. Regular follow-up is important to assess liver function, monitor the shunt, prevent complications, and ensure the best long-term outcomes. Periodic imaging and clinical evaluation may be recommended based on your condition.

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