Portacaval shunting – Indications, Procedure, Risk

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 2 min read
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Shunt - portacaval Portacaval shunting is a surgical treatment to create new connections between two blood vessels in your abdomen. It is used to treat people who have severe liver problems. Description Portacaval shunting is major surgery. It involves a large cut (incision) in the belly area (abdomen). The surgeon then makes a connection between the portal vein (which supplies most of the liver's blood)...

Key Takeaways

  • This article explains Description in simple medical language.
  • This article explains Why the Procedure Is Performed in simple medical language.
  • This article explains Risks in simple medical language.
  • This article explains After the Procedure in simple medical language.
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Shunt – portacaval

Portacaval shunting is a surgical treatment to create new connections between two blood vessels in your . It is used to treat people who have problems.

Description

Portacaval shunting is major surgery. It involves a large cut (incision) in the area (abdomen). The surgeon then makes a connection between the portal (which supplies most of the liver’s blood) and the inferior vena cava (the vein that drains blood from most of the lower part of the body.)

The new connection diverts blood flow way from the liver. This reduces blood pressure in the portal vein and decreases the risk of a tear (rupture) and bleeding from the in the and stomach.

Why the Procedure Is Performed

Normally, blood coming from your esophagus, stomach, and intestines first flows through the liver. When your liver is very damaged and there are blockages, blood cannot flow through it easily. This is called portal hypertension (increased pressure and backup of the portal vein.) The veins can then break open (rupture), causing serious bleeding.

Common causes of are:

  • Alcohol use
  • Blood clots in a vein that flows from the liver to the heart
  • Too much iron in the liver
  • B or C

When portal occurs, you may have:

  • Bleeding from veins of the stomach, esophagus, or intestines (variceal bleeding)
  • Buildup of fluid in the belly (  )
  • Buildup of fluid in the chest (hydrothorax)

Portacaval shunting diverts part of your blood flow from the liver. This improves blood flow in your stomach, esophagus, and intestines.

Portacaval shunting is most often done when transjugular intrahepatic portosystemic shunting (TIPS) has not worked. TIPS is a much simpler, less procedure.

Risks

Risks for anesthesia and surgery in general are:

  • to medicines, problems breathing
  • Bleeding, blood clots, or

Risks of this surgery include:

  • Liver failure
  • Worsening of hepatic encephalopathy (a disorder that affects concentration, mental status, and memory; may lead to coma)

After the Procedure

People with liver disease are at a much higher risk for complications after surgery.

People with severe liver disease that is getting worse may need to be considered for liver transplant.

 

Roddenbery SA, Rosemurgy AS. Technique of portocaval shunting. In: Jarnagin WR, Blumgart LH, eds. Blumgart’s Surgery of the Liver, Biliary Tract and  . 5th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 76B.

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What to tell the doctor

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Questions to ask
  • What is the most likely cause of my symptoms?
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Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
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  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.