[Emergency surgery problems: selective decompression of esophagogastric varices]

Area of Science:

• Hepatology and Surgical Gastroenterology

Background:

• Portosystemic anastomosis is a critical intervention for managing complications of portal hypertension.
• Understanding the physiopathology of portosystemic shunting is essential for surgical decision-making.

Purpose of the Study:

• To explain the physiopathological basis of portosystemic anastomosis.
• To highlight the advantages of selective shunts in modern surgical approaches.
• To present case studies of selective shunt procedures.

Main Methods:

• Review of the physiopathological principles underlying portosystemic shunting.
• Presentation of 6 surgical cases: 4 distal splenorenal shunts and 2 coronarocaval shunts.
• Evaluation of early postoperative outcomes.

Main Results:

• Selective shunts demonstrate general and hemodynamic benefits.
• Initial outcomes in 6 presented cases suggest potential efficacy.
• The study emphasizes the need for careful patient selection.

Conclusions:

• The success of selective shunt surgery is strongly linked to appropriate patient selection.
• Patients with non-decompensated cirrhosis and preserved portal hepatic flow are ideal candidates.
• Further long-term follow-up is required to fully assess the efficacy of these procedures.