Surgical management of noncirrhotic portal hypertension

Abstract

http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)2046-2484/homepage/5-5-reading-marti.htm a video presentation of this article https://www.wileyhealthlearning.com/Activity/3464542/Activity.aspx

<p>Combination of modified Sugiura technique and proximal splenorenal shunt for the management of portal vein thrombosis in noncirrhotic portal hypertension</p>

“…Treatment in NCPH is to reduce portal pressure and to avoid complications such as variceal bleeding 2,6,7. Surgery is indicated if endoscopic therapy cannot control bleeding or other indication such as massive splenomegaly, portal biliopathy, rare blood group, recurrent bleeding or infection, restriction of activities of daily living, inadequate health care facility or want to do a definitive one-time treatment 2,5,6. The goal of surgery in NCPH patient is to reduce portal vein resistance by devascularization of esophageal varices and creating a portosystemic shunt 6–8,11,12.…”

“…Surgery is indicated if endoscopic therapy cannot control bleeding or other indication such as massive splenomegaly, portal biliopathy, rare blood group, recurrent bleeding or infection, restriction of activities of daily living, inadequate health care facility or want to do a definitive one-time treatment 2,5,6. The goal of surgery in NCPH patient is to reduce portal vein resistance by devascularization of esophageal varices and creating a portosystemic shunt 6–8,11,12. In NCPH, surgery options can be divided into esophagogastric devascularization, portosystemic shunt, and portoportal shunt (Rex shunt) 6,7.…”

“…The goal of surgery in NCPH patient is to reduce portal vein resistance by devascularization of esophageal varices and creating a portosystemic shunt 6–8,11,12. In NCPH, surgery options can be divided into esophagogastric devascularization, portosystemic shunt, and portoportal shunt (Rex shunt) 6,7. Various studies have shown shunt patency in 85–98% patients extrahepatic portal vein obstruction and the long‑term survival in >95% patients who undergo central splenorenal shunt, mesocaval shunt, portocaval shunt, side-to-side splenorenal shunt, proximal splenorenal shunt, and mesenterico-left portal bypass 5…”

“…Treatment in NCPH is to reduce portal pressure and to impede variceal bleeding 2,6,7. The goal of surgery in NCPH patient is to minimize portal vein resistance by devascularization of esophageal varices and creating a portosystemic shunt 6–8. The operation can do if patients with portal hypertension get the complication, no response to pharmacologic and endoscopic management.…”

“…The operation can do if patients with portal hypertension get the complication, no response to pharmacologic and endoscopic management. However, surgery can be indicated in recurrent bleeding or infection, restriction of activities of daily living, inadequate health care facility or want to do a definitive one-time treatment 2,5,6…”