Portal Hypertension Surgery
“Portal hypertension” occurs when the veins that serve the abdominal organs become blocked, creating increased blood pressure. This can be caused by a variety of conditions, such as cirrhosis or Budd-Chiari syndrome, just to name a few.

The liver serves many important functions in the body. One of them is to filter blood from the abdominal organs. If the veins are blocked or compressed, the blood backs up into the abdomen. One result is for fluid to settle in the abdomen. Another is an enlarged spleen. There may be gastrointestinal bleeding. Varicose veins may form in the stomach and esophagus.

Despite all of this, some patients still maintain good liver function and do not need a liver transplant. These patients are good candidates for portal hypertension surgery. Surgeons may use a “shunt” to help relieve the pressure within the blood vessels. Transjugular Intrahepatic Portosystemic Shunt (TIPS), for example, is a procedure done by a vascular radiologist while the patient is under local anesthesia, to decrease the risk of life-threatening hemorrhage in patients with advanced liver diseases. Until the early 1990s, the only treatment available was a complex surgical procedure that carried a mortality rate greater than 50% and required a long hospitalization, often lasting several weeks. In contrast, patients who undergo TIPS are usually discharged within 36 hours.