Types of Surgical Portosystemic Shunts

• Side-to-side portacaval shunt: Nonselective surgical shunt that diverts portal flow away from the liver. Used for treatment of Budd-Chiari syndrome.
• Side-to-side mesocaval shunt: Nonselective surgical shunt that diverts portal flow away from the liver.
• Mesoatrial shunt: Nonselective surgical shunt that diverts all portal flow away from the liver.
• Distal splenorenal (Warren) shunt: Selective surgical shunt from gastroesophageal varices that preserves portal blood flow through the liver while lowering variceal pressure. Effectively prevents rebleeding, but still carries a risk of hyperammonemia.

References

Yoshida H, Mamada Y, Taniai N, Tajiri T. New trends in surgical treatment for portal hypertension. Hepatol Res. 2009 Oct;39(10):1044-51.