Portal hypertension, an important consequence of liver disease, results in the development of significant collateral circulation between the portal system and systemic venous drainage (porto-caval circulation). Portal venous congestion causes venous blood leaving the stomach and intestines to be diverted along auxiliary routes of lesser resistance in order to drain to systemic circulation. With time, the small vessels that comprise a collateral path for porto-caval circulation become engorged and dilated. These vessels are fragile and often hemorrhage into the GI tract. (See esophageal, gastric, rectal varices). A<unk>  procedure decreases the effective vascular resistance of the liver through the creation of an alternative pathway for portal venous circulation. By creating a<unk>  from the portal vein to the hepatic vein, this intervention allows portal blood an alternative avenue for draining into systemic circulation. In bypassing the flow-resistant liver, the net result is a reduced pressure drop across the liver and a decreased portal venous pressure. Decreased portal venous pressure in turn lessens congestive pressures along veins in the intestine so that future bleeding is less likely to occur. The reduced pressure also makes less fluid develop, although this benefit may take weeks or months to occur.
Transjugular intrahepatic portosystemic shunt
Distal splenorenal shunt procedure
Portosystemic shunt
Hepatoportoenterostomy
Bidirectional Glenn procedure
Percutaneous hepatic perfusion
Peritoneovenous shunt
Isolated hepatic perfusion