New pathways in portal hypertension surgery.

An individualized treatment of portal hypertension is advocated. The treatment is suggested to be based upon the presence of complications to the disease: bleeding oesophageal varices, insufficient cardia function, regurgitation and oesophagitis, hyperacidity, stomach and duodenal ulcer, ascites and hypersplenism. The choice of method of treatment of the patient depends on the presence of the symptoms. There are several methods available. These can be divided in methods directed against one symptom - unisymptomatic treatment - and methods directed against several symptoms - polysymptomatic treatments. The author advocates a more frequent use of decongestion operations and pexi operations. For acute control of bleeding varices it seems that sclerotherapy is the preferred choice at present.