2024 Volume 30 Issue 1 Pages 10-15
Surgical treatment of portal hypertension is classified into three categories: 1) shunt operations including portocaval shunt and selective shunt that can detour portal venous blood; 2) non-shunt operations such as Hassab's operation and esophageal transection that can decompress esophago-gastric varices by esophago-upper gastric devascularization; 3) other procedures including splenectomy, liver transplantation and mesoportal bypass. Although endoscopic or IVR treatment has become the first choice for esophago-gastric varices, splenectomy and Hassab's operation are still in need in non-surgically intractable cases. Furthermore, these procedures are increasingly performed by minimally invasive surgery using laparoscopy or robotics. Finally, the decision of timing of liver transplantation is critically important in cases of portal hypertension from end-stage liver disease.
