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Surgical management of portal hypertension.
West J Med. 1995 Jun; 162(6):527-35.WJ

Abstract

Portal hypertension is frequently complicated by upper gastrointestinal tract bleeding and ascites. Hemorrhage from esophageal varices is the most common cause of death from portal hypertension. Medical treatment, including resuscitation, vasoactive drugs, and endoscopic sclerosis, is the preferred initial therapy. Patients with refractory hemorrhage frequently are referred for immediate surgical intervention (usually emergency portacaval shunt). An additional cohort of patients with a history of at least 1 episode of variceal hemorrhage is likely to benefit from elective shunt operations. Shunt operations are classified as total, partial, or selective shunts based on their hemodynamic characteristics. Angiographically created shunts have been introduced recently as an alternative to operative shunts in certain circumstances. Devascularization of the esophagus or splenectomy is done for specific indications. Medically intractable ascites is a separate indication for surgical intervention. Liver transplantation has been advocated for patients whose portal hypertension is a consequence of end-stage liver disease. In the context of an increasingly complex set of treatment options, we present an overview of surgical therapy for complications of portal hypertension.

Authors+Show Affiliations

Surgical Service, Long Beach Veterans Affairs Medical Center, CA 90822, USA.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

7618313

Citation

Collins, J C., and I J. Sarfeh. "Surgical Management of Portal Hypertension." The Western Journal of Medicine, vol. 162, no. 6, 1995, pp. 527-35.
Collins JC, Sarfeh IJ. Surgical management of portal hypertension. West J Med. 1995;162(6):527-35.
Collins, J. C., & Sarfeh, I. J. (1995). Surgical management of portal hypertension. The Western Journal of Medicine, 162(6), 527-35.
Collins JC, Sarfeh IJ. Surgical Management of Portal Hypertension. West J Med. 1995;162(6):527-35. PubMed PMID: 7618313.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical management of portal hypertension. AU - Collins,J C, AU - Sarfeh,I J, PY - 1995/6/1/pubmed PY - 1995/6/1/medline PY - 1995/6/1/entrez SP - 527 EP - 35 JF - The Western journal of medicine JO - West J Med VL - 162 IS - 6 N2 - Portal hypertension is frequently complicated by upper gastrointestinal tract bleeding and ascites. Hemorrhage from esophageal varices is the most common cause of death from portal hypertension. Medical treatment, including resuscitation, vasoactive drugs, and endoscopic sclerosis, is the preferred initial therapy. Patients with refractory hemorrhage frequently are referred for immediate surgical intervention (usually emergency portacaval shunt). An additional cohort of patients with a history of at least 1 episode of variceal hemorrhage is likely to benefit from elective shunt operations. Shunt operations are classified as total, partial, or selective shunts based on their hemodynamic characteristics. Angiographically created shunts have been introduced recently as an alternative to operative shunts in certain circumstances. Devascularization of the esophagus or splenectomy is done for specific indications. Medically intractable ascites is a separate indication for surgical intervention. Liver transplantation has been advocated for patients whose portal hypertension is a consequence of end-stage liver disease. In the context of an increasingly complex set of treatment options, we present an overview of surgical therapy for complications of portal hypertension. SN - 0093-0415 UR - https://www.unboundmedicine.com/medline/citation/7618313/Surgical_management_of_portal_hypertension_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/7618313/ DB - PRIME DP - Unbound Medicine ER -