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Splenectomy and Shunt Surgeries in Dhakuria

Splenectomy and Shunt Surgeries

Splenectomy and Shunt Surgeries in Dhakuria

Splenectomy is a surgical procedure where an infected spleen is either partially or completely removed via surgical intervention. The spleen is an important organ in our body as it plays a vital role in the body's defence mechanism. There are many etiological factors contributing to spleen infection, such as viral hepatitis and bacterial infections like endocarditis and malaria. Some liver diseases like cirrhosis, chronic hepatitis, and portal hypertension also cause spleen infection, which warrants intervention.

Distal Splenorenal Shunt (DSRS)

The Distal Splenorenal Shunt is performed to ease the pressure in the portal vein. The portal vein carries blood from the digestive system to the liver. A Distal Splenorenal Shunt assists in preventing or controlling blood flow by diverting away from the portal vein. In Distal Splenorenal Surgery, the splenic vein under hypertension is gently detached from the portal vein and then reattached to the renal vein.

Before the Surgery

Before the surgery commences, there are a few diagnostic tests to be done, such as:

  • Angiogram
  • Complete Blood Count
  • Upper GI Endoscopy

After carrying out all the diagnostic tests, the patient must provide all the medical history related to medicines, diet, or any other prior treatments they have undergone. Manipal Hospitals, Dhakuria, West Bengal, provides top-notch equipment and facilities for our patients.

After the Surgery

Post-operative procedures, like monitoring your vitals and shunt performance, are regularly monitored. Patients must be hospitalised for at least about a week until recovery. Postoperatively, the patient is provided with the following:

  • Intravenous cannula (IV), which carries fluids and medicines into the bloodstream
  • A nasogastric tube to eliminate the gases and fluids
  • A catheter into your bladder to drain urine

 

FAQ's

Splenectomy is done when there is an irreversible injury to the organ, causing its protective layer to rupture. A ruptured spleen is a life-threatening condition which leads to internal bleeding.

Causes of Splenectomy include injury-related causes such as road accidents and severe blows to the abdomen during harsh physical sports such as boxing and football.

Auto-splenectomy is associated with certain conditions, such as sickle-cell disease, where the spleen shrivels up and stops functioning, which leads to Auto-Splenectomy.

Auto-immune disorders, like idiopathic thrombocytopenic purpura, are conditions in which antibodies target blood platelets, which inhibit the clotting mechanism. So, the removal of the spleen aids against the condition, as the spleen is responsible for the production of antibodies.

Complications or risks are:

  • Allergic reactions to the anaesthesia
  • Bleeding and infections
  • Fluid buildup in the abdomen (ascites)
  • Encephalopathy

Portal hypertension is elevated pressure in the portal venous system. The portal vein is a major vein connecting to the liver.

 The liver damage caused by portal hypertension is caused by:

  •  Alcohol use
  • Biliary cirrhosis
  • Blood clots
  • Viral hepatitis

If your spleen is too big to be removed with a Laparoscopy, you might need Open Surgery. If bleeding is excessive, your surgeon might potentially employ an open procedure. If something goes wrong, a Laparoscopy could always be changed to Open Surgery. A Laparoscopy and an Open Surgery follow similar procedures. The primary distinction is that your surgeon makes a single, bigger abdominal incision rather than several smaller ones.

Your risk of blood clots and infections—including potentially catastrophic ones—increases after a Splenectomy. Without a spleen, even mild infections can escalate quickly and cause major health problems. For instance, an overwhelming post-splenectomy infection (OPSI), a type of severe sepsis, can be lethal in the absence of medical intervention. It's critical to heed the advice of your medical professional to avoid infections and to seek prompt treatment if you exhibit symptoms. Quick action could save your life.

Living a normal life after a Splenectomy is possible if you take precautions to prevent infection. Still, there’s a higher likelihood of getting an infection or having a related complication (including death) if you’re living without a spleen. This is why it’s so important to get vaccinated and follow your healthcare provider’s guidance to protect yourself.

Controlling bleeding and reducing pressure in your portal vein are the two main objectives of Splenorenal Shunt Therapy. With DSRS, an existing vein is used to establish a blood flow route, or shunt, by surgery. Another treatment called Transjugular Intrahepatic Portosystemic Shunt (TIPS) connects your portal vein directly to the hepatic vein, which is the vein that delivers blood from your liver to your heart, using a minimally invasive (catheter-based) technique. In general, TIPS is more widely used than DSRS. There are two more splenorenal shunts:

Proximal Splenorenal Shunt: Your spleen may need to be removed for surgeons to implant this shunt.

Spontaneous Splenorenal Shunt: When blood is unable to pass through your liver, it reverses its flow. SSRS happens spontaneously as a result of advanced liver disease.

The two most typical ones are:

Fixed pressure valves: These control the rate at which CSF fluid flows by applying a preset pressure. Pressure valves that can be adjusted: These valves control the flow of CSF fluid by adjusting a pressure setting.

Your provider typically asks about your medical history and does a body checkup. You also receive tests to check your overall health, how well your liver works, and the severity of the portal hypertension. Tests may include:

  • Blood tests
  • Electrocardiogram  
  • Chest X-ray
  • Liver Function Tests

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