Historical aspects of portal hypertension surgery: evolution of thinking

Abstract

The paper presents the evolution of views on the surgery of portal hypertension, as well as some historical aspects of its development. The authors considered the main types of surgical interventions to be performed in this pathology. It is noted that in the middle of the 20th century, the direct portacaval anastomosis gained the widest acceptance of all the proposed types of vascular anastomoses. A number of surgeons considered it a classical method of treatment in portal hypertension. Thereafter, the indirect portacaval anastomosis proved to have the best outcomes. The advantage of portacaval anastomoses in comparison with other modifications of surgeries was substantiated by a significant decrease in portal pressure and disappearance of oesophageal varices after developing the anastomosis. Surgical treatment of patients with liver cirrhosis and portal system thrombosis reasonably requires closer attention of doctors in various fields. Such patients should be managed in specialized clinics and well-equipped medical centers.