[Surgical treatment of portal hypertension]

Abstract

From the surgical point of view is reported on the therapy of the portal hypertension by operations of anastomoses decreasing the pressure. Here the treatment of the haemorrhage of the oesophageal varices dangerous to life is in the first place. The porto-caval shunt is justified and successful in this emergency situation, since it has the decisive advantages of a short time of operation and an optimal release of pressure. Obstructive operations are indicated only in exceptional cases. Issuing from the haemodynamic criteria and from the moment of haemorrhage, the indication to the typical shunt operations is explained. Hereby it is established that the surgery of portal vessels is still considerably burdened by the postoperative encephalopathy. The modern anastomotic operations are directed to its prevention. Finally the author adopts a definite attitude to the peculiarities of the hypertension of the portal vein in children and it is in short referred to the operative treatment of the therapy-resistent ascites as well as of the hypersplenism.