Splenectomy & Shunt Surgery for Portal Hypertension in Noida
Portal hypertension without cirrhosis — extrahepatic portal vein obstruction (EHPVO) in children and young adults, and non-cirrhotic portal fibrosis (NCPF) — causes a huge spleen, low blood counts and life-threatening bleeding from varices. When endoscopic banding fails or hypersplenism is severe, removing the spleen and creating a shunt between the splenic vein and the kidney vein lowers the pressure permanently. This surgery draws on the same vascular skills as liver transplantation.
Who benefits
Patients with EHPVO or NCPF who have recurrent variceal bleeding despite banding, massive splenomegaly with pain or low platelets, growth failure in children, or who live far from endoscopy services. Cirrhotic patients are usually better served by TIPS or transplant.
The operation
The spleen is removed and the splenic vein is joined end-to-side to the left renal vein (proximal splenorenal shunt), diverting portal blood into the systemic circulation at a lower pressure. Alternatively, in selected patients, the varices are devascularised (Sugiura-type procedure). Operating time is 3–5 hours.
Results
Rebleeding rates after a well-constructed shunt are low, blood counts normalise, and patients return to school or work within 6–8 weeks. Lifelong vaccination against encapsulated bacteria and prompt treatment of fevers are needed after splenectomy.
Conditions treated with splenectomy & shunt surgery for portal hypertension
Why choose Dr Manoj Gupta for splenectomy & shunt surgery for portal hypertension
- Senior Director & Head of Robotic and Laparoscopic GI Surgery at Yatharth Super Speciality Hospital — full robotic suite, liver ICU and 24×7 emergency team.
- Trained where the difficult cases go: DNB in GI Surgery at Sir Ganga Ram Hospital, liver transplant fellowships at Apollo and Ganga Ram.
- 500+ liver transplants — the bleeding control and bile-duct skills that make every abdominal operation safer.
- Straight answers. Dr Gupta reviews your scans himself and only recommends surgery when it will help.
Questions about splenectomy & shunt surgery for portal hypertension
Is shunt surgery still relevant in the era of endoscopy?
Yes, for non-cirrhotic portal hypertension — common in India — where the liver itself is healthy and a one-time operation can end years of banding sessions and bleeding episodes.
Can this be done laparoscopically?
Splenectomy alone can be laparoscopic in moderate-sized spleens; shunt construction is generally done open for precision.
Other procedures
Not sure if you need surgery? Ask first.
Bring your reports for a clear, honest opinion. Same-day and evening appointments available.