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Abstract Surgical shunts for decompression of portal hypertension fall into three broad groups Total, partial nd selective portal systemic shunts. Currently, radiologic ”ntervention with creation of an intrahepatic portal ystemic shunt is being widely applied. Total portal systemic shu~ts are those operations that t least theoretically totally divert portal blood flow away rom the liver and into the systemic venous circulation. tandard portacaval decompression effectively controls emorrhage from esophageal varices. However, long term .Vlvors of these procedures are at substantial risk for ccelerated liver failure. In 1967 Warren and associates introduced an operation hat would selectively decompress the velns in the sophagogastric area while still maintaining hepatopetal ortal blood flow. This prototype selective shunt. D.S.R.S . . e. creation of a shunt between the distal splenic vein and he left renal vein. Subsequent angiographic study of the emodynamic course in D.S.R.S. patients found that this peration gradually loses its selectivity which cast doubt n its ability to maintain longterm hepatopetal portal flow n most patients. Also, D.S.R.S. is recognized as having a igh incidence of postoperative ascites and occasionaly . |