title: [Emergency surgery problems: selective decompression of esophagogastric varices].
abstract: The physiopathological premisses of portosystemic anastomosis and the modern approach to this question are explained. Stress is laid on the general and haemodynamic advantages offered by selective shunts and 6 cases (4 distal splenorenal and 2 coronarocava shunts) are presented. As yet the postoperative period is not long enough to enable a final judgement to be formed. However, it can be stated that the success of this form of management is primarily determined by the proper choice of candidates, i.e. patients with non-decompensated initial cirrhosis and unimpaired portal hepatic flow.
mesh_terms: D000328:Adult; D000368:Aged; D004322:Drainage / Q000379:methods; D004630:Emergencies; D004932:Esophageal and Gastric Varices / Q000601:surgery*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011172:Portography / Q000379:methods; D011183:Postoperative Complications / Q000503:physiopathology; D013270:Stomach / Q000098:blood supply*; D014648:Varicose Veins / Q000601:surgery*
vernacular_title: Problemi in chirurgia d'urgenza: la decompressione selettiva delle varici esofago-gastriche.