Distal splenorenal shunt procedure


In medicine, a distal splenorenal shunt procedure, also splenorenal shunt procedure and Warren shunt, is a surgical procedure in which the distal splenic vein is attached to the left renal vein. It is used to treat portal hypertension and its main complication. It was developed by W. Dean Warren.

Splenopancreatic and gastric disconnection (SPGD)

DSRS is typically done with splenopancreatic and gastric disconnection, as it improves the outcome.

Comparison to TIPS

Survival with a transjugular intrahepatic portosystemic shunt 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 bleeding at the expense of hepatic encephalopathy; however, TIPS appears to have more shunt dysfunction and lead to more encephalopathy and bleeds. DSRS appears to be more cost effective than TIPS.