title: [The current state of the surgery of portal hypertension].
abstract: Surgery for bleeding portal hypertension has evolved widely in the last decades. The surgical procedures that preserve portal blood flow are the first operative choice for well selected patients. Operative procedures that deprive the portal blood flow to the liver, are most likely to promote deterioration of liver function in the late postoperative period. The operation most frequently performed are the selective shunts (Warren) and the thoraco abdominal devascularization (Sugiura). The best results are obtained in patients with a good liver function that are operated in an elective fashion. Non-selective shunts have a restricted indication and low diameter porto systemic shunts are still under evaluation. The combination of drug therapy and/or sclerotherapy with surgery appears to improve survival. Liver transplants are indicated for those patients with associated liver failure. For patients with good liver function, surgery is the therapy of choice.
authors.affiliation: Clínica de Hipertensión Portal, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.
authors.forename: M A
authors.initials: MA
authors.lastname: Mercado
authors.forename: H
authors.initials: H
authors.lastname: Orozco
mesh_terms: D003131:Combined Modality Therapy; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D016031:Liver Transplantation; D011168:Portal System / Q000503:physiopathology; D011170:Portasystemic Shunt, Surgical
vernacular_title: Estado actual de la cirugía de hipertensión portal.