Advanced Surgical Management for High Portal Vein Pressure

Surgery for portal hypertension is performed in selected patients to manage complications caused by increased pressure in the portal vein, which carries blood from the intestines to the liver. When medications and endoscopic treatments are not sufficient, surgical intervention can play a life-saving role.

With proper patient selection and expert surgical care, surgery can significantly improve outcomes and quality of life.

What is Portal Hypertension?

Portal hypertension is a condition where there is abnormally high blood pressure in the portal venous system, usually due to chronic liver disease such as cirrhosis. This increased pressure can lead to serious complications.

Common complications include:

• Bleeding from food pipe (oesophageal) or stomach varices
• Ascites (fluid accumulation in the abdomen)
• Enlarged spleen
• Low platelet count
• Recurrent gastrointestinal bleeding
• Fatigue and weakness

Timely management is essential to prevent life-threatening complications..

What is Surgery for Portal Hypertension?

Surgical treatment aims to reduce portal vein pressure and prevent complications, especially variceal bleeding.

Common surgical options include:

• Devascularization procedures (reducing blood flow to bleeding-prone veins)
• Splenectomy in selected cases
• Other specialized procedures depending on the patient’s condition

The choice of surgery depends on:

• Severity of portal hypertension
• Underlying liver disease
• Frequency of bleeding episodes
• Overall health of the patient

Who May Need Surgery for Portal Hypertension?

Surgery is usually recommended for patients who:

• Have recurrent variceal bleeding despite medical treatment
• Do not respond adequately to endoscopic therapy
• Have severe enlargement of the spleen with low blood counts
• Have complications that are not controlled with medicines
• Are not suitable candidates for certain non-surgical interventions?

Each patient is thoroughly evaluated before surgery is advised.

Benefits of Surgery for Portal Hypertension

This surgery is commonly advised for patients with:

• Liver cancer detected at an operable stage
• Cancer that has spread to the liver (metastatic tumours)
• Large benign liver tumours causing symptoms
• Recurrent liver infections or abscesses

Each patient is carefully evaluated using imaging scans and blood tests before recommending surgery.

Benefits of Liver Resection

• Reduces the risk of life-threatening bleeding
• Improves blood flow dynamics
• Reduces hospital admissions due to bleeding episodes
• Improves overall quality of life