Article Sidebar

Submitted
18 August 2023
Accepted
17 November 2023
Published
10 September 2023
Download
PDF
Statistic
Read Counter : 153 Download : 121

Main Article Content

Abstract

Highlights:


1. This study systematically reviewed the efficacy, clinical outcomes, and safety of the splenorenal shunt procedure with a comprehensive and meticulous approach.
2. The splenorenal shunt procedure is an innovative surgical intervention that offers a viable option for the management of portal hypertension.


 


Abstract


Portal hypertension is the second most common gastrointestinal bleeding in cirrhosis and non-cirrhosis patients. The splenorenal shunt surgery is a potential intervention that may be considered for portal hypertension patients with clinical symptoms such as upper gastrointestinal bleeding caused by the rupture of gastro-esophageal varices. In this study, the researchers aimed to analyze the efficacy, clinical outcomes, and safety of splenorenal shunt surgery in portal hypertension patients. The sources were obtained from electronic search databases, including PubMed, Google Scholar, and ScienceDirect, using the keywords "Efficacy," "Safety," and "Clinical Outcomes." in relation to splenorenal shunt surgery in portal hypertension patients. The researchers set specific criteria for inclusion and exclusion to select the articles. This systematic review revealed the efficacy of the splenorenal shunt procedure with favorable outcomes. The success rate of splenorenal shunt surgery in reducing the clinical symptoms of portal hypertension varied between 66% and 100%. The prevailing complications observed in this study were shunt thrombosis, rebleeding, and thrombocytopenia. However, notable improvements could be achieved with general treatment. In terms of short- and long-term clinical outcomes, the splenorenal shunt procedure demonstrated favorable results. It can be concluded that splenorenal shunt surgery provides excellent clinical outcomes and should be considered a viable treatment option for patients with both cirrhotic and non-cirrhotic portal hypertension.

Keywords

portal hypertension splenorenal shunt efficacy clinical outcomes Human and health

Article Details

License

Copyright (c) 2023 Folia Medica Indonesiana

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

  • Folia Medica Indonesiana is a scientific peer-reviewed article which freely available to be accessed, downloaded, and used for research purposes. Folia Medica Indonesiana (p-ISSN: 2541-1012; e-ISSN: 2528-2018) is licensed under a Creative Commons Attribution 4.0 International License. Manuscripts submitted to Folia Medica Indonesiana are published under the terms of the Creative Commons License. The terms of the license are:

    Attribution ” You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.

    NonCommercial ” You may not use the material for commercial purposes.

    ShareAlike ” If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.

    No additional restrictions ” You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.

    You  are free to :

    Share ” copy and redistribute the material in any medium or format.

    Adapt ” remix, transform, and build upon the material.

How to Cite
Yan Efrata Sembiring, Heroe Soebroto, Ito Puruhito, Dhihintia Jiwangga Suta Winarno, I Gusti Agung Made Adnyanya Putra2, Sri Pramesthi Wisnu Bowo Negoro, Ketut Putu Yasa, & Jeffrey Jeswant Dillon. (2023). Efficacy, Safety, and Clinical Outcomes of Splenorenal Shunt Surgery as a Therapeutic Intervention for Portal Hypertension Patients. Folia Medica Indonesiana, 59(3), 302–312. https://doi.org/10.20473/fmi.v59i3.48843
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. Addeo P, De Mathelin P, Averous G, et al (2020). The left splenorenal venous shunt decreases clinical signs of sinistral portal hypertension associated with splenic vein ligation during pancreaticoduodenectomy with venous resection. Surgery 168, 267–273. doi: 10.1016/j.surg.2020. 04.033.
  2. Anand U, Kumar R, Priyadarshi RN, et al (2020). Proximal splenorenal shunt surgery for bleeding gastric varices in non-cirrhotic portal hypertension. Cureus. doi: 10.7759/cureus.10464.
  3. Biju P, Midha K, Gupta S, et al (2019). Proximal splenorenal shunt in a rare renal vein anomaly: A case report. Cureus. doi: 10.7759/cureus.4754.
  4. Cortez AR, Kassam A-F, Jenkins TM, et al (2019). The role of surgical shunts in the treatment of pediatric portal hypertension. Surgery 166, 907–913. doi: 10.1016/j.surg.2019.05.009.
  5. Dasanayake B, P Kanchana W, Darmapala A, et al. (2020). Left adrenalectomy and proximal splenorenal shunt. Kerala Surgical Journal 26, 212. doi: 10.4103/ksj.ksj_27_20.
  6. Espinós EL-, Hernández V, Domí­nguez-Escrig JL, et al (2018). Metodologí­a de una revisión sistemática. Actas Urológicas Españolas 42, 499–506. doi: 10.1016/j.acuro.2018.01.010.
  7. Gairing SJ, Kloeckner R, Pitton MB, et al (2021). Multidisciplinary approach to the complex treatment for non-cirrhotic portal hypertension – case-report-based discussion. Zeitschrift für Gastroenterologie 59, 43–49. doi: 10.1055/a-1330-9827.
  8. Gao Z-Q, Han Y, Li L, et al (2020). Pharmacological management of portal hypertension: current status and future. Chinese Medical Journal (Engl) 133, 2362–2364. doi: 10.1097/CM9.0000000000001004.
  9. Gioia S, Nardelli S, Ridola L, et al (2020). Causes and management of non-cirrhotic portal hypertension. Current Gastroenterology Reports 22, 56. doi: 10.1007/s11894-020-00792-0.
  10. Gómez CA, Romaní­ Pozo D, Herrera Chávez G, et al (2021). Laparoscopic splenectomy and proximal splenorenal shunt for portal hypertension due to portal vein thrombosis in a patient with protein S deficiency. Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru 41, 48–51. Available at: http://www.ncbi.nlm.nih.gov/pubmed/34347772.
  11. Gunarathne LS, Rajapaksha H, Shackel N, et al. (2020). Cirrhotic portal hypertension: From pathophysiology to novel therapeutics. World Journal of Gastroenterology 26, 6111–6140. doi: 10.3748/wjg.v26.i40.6111.
  12. Gupta S, Pottakkat B, Kalayarasan R, et al (2022). Use of caudal pancreatectomy as a novel adjunct procedure to proximal splenorenal shunt in patients with noncirrhotic portal hypertension: A retrospective cohort study. Annals of Hepato-Biliary-Pancreatic Surgery 26, 178–183. doi: 10.14701/ahbps.21-106.
  13. Gupta S, Venkata Srinivas G, Chandrasekar AS, et al (2019). Splenoadrenal shunt for noncirrhotic portal hypertension. Indian Journal of Surgery 81, 28–31. doi: 10.1007/s12262-017-1706-z.
  14. Irawan H, Mulyawan IM (2019). Combination of modified Sugiura technique and proximal splenorenal shunt for the management of portal vein thrombosis in noncirrhotic portal hypertension. Clinical and Experimental Gastroenterology 12, 149–156. doi: 10.2147/CEG. S188200.
  15. Iwakiri Y, Trebicka J (2021). Portal hypertension in cirrhosis: Pathophysiological mechanisms and therapy. JHEP Reports 3, 100316. doi: 10.1016/j. jhepr.2021.100316.
  16. Khamag O, Numanoglu A, Rode H, et al (2023). Surgical management of extrahepatic portal vein obstruction in children: advantages of MesoRex shunt compared with distal splenorenal shunt. Pediatric Surgery International 39, 128. doi: 10.1007/s00383-023-05411-3.
  17. Kibrit J, Khan R, Jung BH, et al (2018). Clinical assessment and management of portal hypertension. Seminars in Interventional Radiology 35, 153–159. doi: 10.1055/s-0038-1660793.
  18. Lemoine C, Lokar J, McColley SA, et al (2019). Cystic fibrosis and portal hypertension: Distal splenorenal shunt can prevent the need for future liver transplant. Journal of Pediatric Surgery 54, 1076–1082. doi: 10.1016/j.jpedsurg.2019.01.035.
  19. Malviya NK, Behari A, Kumar A, et al (2022). Unconventional shunts in extrahepatic portal venous obstruction”A retrospective review. Journal of Clinical and Experimental Hepatology 12, 503–509. doi: 10.1016/j.jceh.2021.05.007.
  20. Moher D, Shamseer L, Clarke M, et al (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews 4, 1. doi: 10.1186/ 2046-4053-4-1.
  21. Nordmann T, Schlabe S, Feldt T, et al (2021). TIPS and splenorenal shunt for complications of portal hypertension in chronic hepatosplenic schistosomiasis–A case series and review of the literature ed. Fairfax KC. PLOS Neglected Tropical Diseases 15, e0010065. doi: 10.1371/journal.pntd.0010065.
  22. Oliver TI, Sharma B, John S (2023). Portal hypertension. Available at: http://www.ncbi.nlm. nih.gov/pubmed/23363263.
  23. Page MJ, McKenzie JE, Bossuyt PM, et al (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Systematic Reviews 10, 89. doi: 10.1186/s13643-021-01626-4.
  24. Papandria DJ, Besner GE, Moss RL, et al (2019). Operative dictations in pediatric surgeryed. Papandria DJ, Besner GE, Moss RL & Diefenbach KA. Springer International Publishing, Cham. Available at: http://link.springer.com/10.1007/978 -3-030-24212-1.
  25. van Praet KM, Ceulemans LJ, Monbaliu D, et al (2021). An analysis on the use of Warren's distal splenorenal shunt surgery for the treatment of portal hypertension at the University Hospitals Leuven. Acta Chirurgica Belgica 121, 254–260. doi: 10.1080/00015458.2020.1726099.
  26. Ravindranath A, Sen Sarma M, Yachha SK, et al (2020). Outcome of portosystemic shunt surgery on pre"existing cholangiopathy in children with extrahepatic portal vein obstruction. Journal of Hepato-Biliary-Pancreatic Sciences 27, 141–148. doi: 10.1002/jhbp.692.
  27. Rehman Z, Nazir Z (2019). Distal Splenorenal Shunt (DSRS) in children with extrahepatic portal hypertension. Journal of the College of Physicians and Surgeons Pakistan 29, 1228–1229. doi: 10.29271/jcpsp.2019.12.1228.
  28. Rockey DC (2017). Advances in hepatology. Current Opinion in Gastroenterology 33, 113–114. doi: 10.1097/MOG.0000000000000357.
  29. Terwagne N, Marique L, Dieu A, et al (2022). The use of autologous peritoneum in surgery of portal hypertension: H-shape splenorenal shunt using simple layer peritoneal tube. Acta Gastro Enterologica Belgica 85, 643–645. doi: 10.51821/ 85.4.9665.
  30. Woerner A, Shivaram G, Koo KSH, et al (2018). Clinical and imaging predictors of surgical splenorenal shunt dysfunction in pediatric patients. Journal of Pediatric Gastroenterology & Nutrition 66, e139–145. doi: 10.1097/MPG.00000 00000001931.
  31. Yao Q, Chen W, Yan C, et al (2021). Efficacy and safety of treatments for patients with portal hypertension and cirrhosis: A systematic review and bayesian network meta-analysis. Frontiers in Medicine. doi: 10.3389/fmed.2021.712918.
  32. Yi F, Guo X, Wang L, et al (2021). Impact of spontaneous splenorenal shunt on liver volume and long"term survival of liver cirrhosis. Journal of Gastroenterology and Hepatology 36, 1694–1702. doi: 10.1111/jgh.15386.