Introduction
- Ligation of vessels shunting blood between portal vein and caudal vena cava or other systemic vein, eg azygos.
SHOULD NOT BE ATTEMPTED IN PRACTICE - REFER FOR SURGERY.
Uses
- Surgical management of congenital portosystemic shunts
.
Aims of surgery
- Restore nutrient vascular supply.
- Avoid further liver atrophy and fibrosis.
- Prognostic evaluation via pressure measurement at surgery and biopsy.
Advantages
- Clinical signs often resolve completely.
Disadvantages
- Not all shunts amenable to surgery.
- Intrahepatic shunts may require hepatic vascular occlusion for access to shunt vessel(s).
- Hepatic encephalopathy must be controlled prior to surgery .
- Specialized equipment required.
- Complex surgery.
Requirements
Materials required
Minimum equipment
- Water manometer or pressure transducer.
Sequelae
Complications
- Same as standard laparotomy .
Prognosis
- Favorable depending on type of shunt.
- Clinical signs often resolve completely.
- Long-term prognosis unclear but animals may have a shortened lifespan if shunt ligation incomplete.
Sources
Publications
- Heldmann E et al (1999) Use of propofol to manage seizure activity after surgical treatment of portosystemic shunts. JSAP 40, (12) 590-4.
- Schunk C M (1997) Feline portosystemic shunt. Semin Vet Med Surg (Small Anim) 12 (1), 45-50.
- Forster-van Hijfte M A et al (1996) Per rectal portal scintigraphy in the diagnosis and management of feline congenital portosystemic shunts. JSAP 37 (1), 7-11.
