[Should patients with portal hypertension undergo surgery?]

There is a noticeable similarity between the surgery of cancer and that of portal hypertension secondary to hepatic cirrhosis. The problems associated with the basic disease and with the surgical techniques used for its treatment are such that therapy should be determined by selection criteria, both when bleeding occurs and between bleeds. Highly experienced internists and surgeons are required and it is therefore advantageous if portal hypertension patients are referred to and concentrated in a small number of specialist centers. There the decision to operate should continue to be based on predetermined criteria, bearing in mind the patient's basic disease. If cirrhosis is in the foreground, as is so often the case, long-term social care should receive greater emphasis than hitherto in planning postoperative management.