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March 1974

Extrahepatic Portal Hypertension: A Retrospective Analysis of 127 Cases and Associated Clinical Implications

Author Affiliations

New York
From the Department of Surgery, College of Physicians and Surgeons, Columbia University and the Presbyterian Hospital of New York.

Arch Surg. 1974;108(3):338-341. doi:10.1001/archsurg.1974.01350270068012

A retrospective study of 129 cases of extrahepatic portal hypertension was undertaken in an attempt to evaluate the relative merits of conservative versus surgical approaches to the condition. The complex interrelationships of multiple surgical procedures were untangled when possible, but the "need to intervene" has distorted the natural history of the disease so that statistical comparisons should be thought of as trends and not absolutes. There is obvious need for a prospective study of the disease; however, this must be developed as a multiinstitutional program because of the relatively low incidence of the disease and the great inconstancy of bleeding patterns in individual cases. Currently, the mesocaval shunt provides the best results and the esophagogastrectomy should be undertaken only in cases when a shunt is not possible and there is a high risk of massive bleeding from large varices.