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Venous bypass surgery redirects blood flow to relieve pressure on the portal vein, which carries blood from the stomach to the liver. This surgery is a permanent solution to internal bleeding caused by portal hypertension, often due to liver failure or cirrhosis. There are four types of venous bypass procedures, with varying incision sizes and recovery times. Transvenous intrahepatic portosystemic shunting (TIPS) is the least invasive and has a faster recovery time.
Sugar venous bypass is used to redirect blood flow in the body from one vein to another. The most common venous bypass surgery is for the portal vein. This vein carries blood from the stomach to the liver. This type of surgery is done only to release pressure on the portal vein that is causing internal bleeding.
The portal vein is one of the major veins responsible for the smooth movement of a large volume of blood. Venous bypass surgery is the permanent solution to uncontrolled internal bleeding caused by portal hypertension. Portal hypertension occurs when the liver is unable to absorb blood flow from the intestines. The pressure in the vein increases as the body looks for other routes to channel blood flow. The most common reasons for liver problems are liver failure and cirrhosis.
In venous bypass surgery, the vein that directs blood from the bowel to the liver is detached and reattached to the main venous system. Bypassing the liver allows the body to move blood without putting excessive pressure on the veins. Portal hypertension and subsequent internal bleeding are found in about 40% of patients with cirrhosis, and half are fatal. Portal bypass surgery is performed on surviving patients.
There are four types of venous bypass procedures: portacaval shunt, splenorenal shunt, mesocaval shunt, and transvenous intrahepatic portosystemic shunt (TIPS). All four surgeries are performed under general anesthesia is a hospital. This is a major surgery and the risk to the patient is quite high, as they are usually in poor health.
The portacaval shunt diverts blood from the portal vein into the inferior vena cava. This is the most common method of venous bypass. The inferior vena cava is a main vein that directs blood to the heart. In splenorenal shunt, the kidney or renal vein is used to attach the splenic vein. This vein is part of the larger portal vein and is large enough to accommodate blood flow.
The mesocaval shunt uses another section of the portal vein, called the superior mesenteric vein, to connect with the inferior vena cava. These three methods all require a large incision in the patients abdomen and have a long surgical recovery time. Many patients require extensive support after this type of surgery.
Transvenous intrahepatic portosystemic shunting (TIPS) uses specially designed equipment and an X-ray camera to create a shunt using the actual liver. A stent, or artificial vein, is used to connect the portal vein to another vein. This procedure only requires a small nick in the skin and has a faster recovery time.
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