Mitra Shunt: Historical Attribution
I was unable to find any evidence in the provided literature regarding a "Mitra shunt" or its originator. The term does not appear in any of the guideline documents or research studies provided, which comprehensively cover various portosystemic shunt procedures for portal hypertension.
Established Splenorenal Shunt Procedures
The literature does describe several well-established splenorenal shunt techniques:
Distal Splenorenal Shunt (Warren Shunt)
- This is the most commonly referenced selective shunt procedure in modern practice 1, 2
- Recommended by the American College of Radiology for Child-Pugh class A or B cirrhosis patients with recurrent variceal bleeding refractory to endoscopic and medical treatment 2
- Shows comparable outcomes to TIPS in terms of rebleeding, encephalopathy, and survival, but with longer shunt patency (45 months versus 22 months; P = 0.04) 1, 2
Proximal Splenorenal Shunt (Linton Shunt)
- Involves splenectomy with central splenorenal anastomosis 3, 4
- Particularly useful when there is large spleen, severe hypersplenism, and a shuntable splenic vein 3
- In pediatric extrahepatic portal venous obstruction, shows 15-year survival rate of 95% with operative mortality of only 1.9% 4
Side-to-Side Lienorenal Shunt (SSLR)
- Performed without splenectomy, preserving splenic function 3, 5, 6
- Suitable when there is mild splenomegaly, mild hypersplenism, and a shuntable splenic vein 3
- Shows 87% shunt patency at mean 54-month follow-up with 10% rebleeding rate 5
Possible Clarification
If you are referring to a specific variant or eponymous procedure, it may be described under different terminology in the surgical literature, or it may be a regional or historical term not captured in these contemporary guidelines and research studies.