Current role of surgery for the treatment of portal hypertension

Annals of Hepatology

Miguel Angel Mercado, MD¹  Roberto Cisneros De-ajuria, MD²  Carlos Chan, MD²  Noel Salgado-Nesme, MD²  Hйctor Orozco, MD²  Raъl Gбlvez-Treviño, MD²  Francisco Javier Anthón, MD²  Guillermo Ramos-Gallard, MD² 

[1] Address for correspondence:;Department of Surgery. Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirбn”;

关键词: Portal hypertension;    surgery;    β blockers;    endoscopic therapy;   

DOI  :  

来源: DOAJ

【 摘 要 】

Portal hypertension surgery has evolved widely in the last decades. Since the first surgical shunt was done in 1945 for the treatment of recurrent hemorrhage, many surgical options have been developed including selective shunts, low diameter shunts and extensive devascularization procedures. Many of them have been studied and compared showing their advantages and disadvantages, evolving also their role in the therapeutic armamentarium.Surgery is nowadays a second line treatment option (after β blockers and endoscopic therapy), and it’s main indication is for patients whose main and only problem is history of bleeding, with good liver function (Child-Pugh A). For emergency situations it has a very limited role and for primary prophylaxis virtually has also no role. Patients with good liver function, electively operated with portal blood flow preserving procedures are the patients that benefit from surgical treatment. Patients with a bad liver function are better candidates for a liver transplant.

【 授权许可】

Unknown