LIVER & PORTAL HYPERTENSION
- Surgery for liver diseases commonly includes surgery for benign lesions like hydatid cyst surgery which is mainly done laparoscopically.
- Dr. Abhishekh MItra Best Portal hypertension specialist in Gurgaon.
- Liver trauma is dealt with at our centre. All facilities to deal with liver injuries are available. We have a good blood bank with all component facilities. OT also has the latest technology for liver surgery in form of CUSA, Argon beam coagulator etc.
- Portasystemic vascular shunt procedures like splenectomy and lieno-renal shunt and other shunt procedures are being performed regularly. In cases where portal hypertension patients are not manageable by endoscopic means, the surgical procedures required in all these problems are regularly done. Oesophago gastric devascularisation is done in patients with persistent bleeding where endoscopic treatment fails or is not possible.
- Other surgery for liver diseases mainly includes major and minor liver resections. These are done for liver cancers – both primary and metastatic. Right, Left and extended hepatectomies are being performed.
SYMPTOMS
Liver & Portal Hypertension Includes
- Gastrointestinal bleeding marked by black, tarry stools or blood in the stools, or vomiting of blood due to the spontaneous rupture and hemorrhage from varices
- Ascites (an accumulation of fluid in the abdomen)
- Encephalopathy or confusion and forgetfulness caused by poor liver function
- Reduced levels of platelets, blood cells that help form blood clots, or white blood cells, the cells that fight infection.
CONDITION & TREATMENTS
Endoscopic therapy
This is usually the first line of treatment for variceal bleeding and consists of either banding or sclerotherapy. Banding is a procedure in which a gastroenterologist uses rubber bands to block off the blood vessel to stop bleeding. Sclerotherapy is occasionally used when banding cannot be used and is a procedure in which a blood-clotting solution is injected into the bleeding varices to stop bleeding.
Medications
Nonselective beta-blockers (nadolol or propranolol) may be prescribed alone or in combination with endoscopic therapy to reduce the pressure in varices and further reduce the risk of bleeding. Nonselective beta blockers are also prescribed to prevent a first variceal hemorrhage in a patient with varices that are felt to be at risk for bleeding. Esophageal variceal banding has also been used for that purpose, especially in patients who can’t take beta blockers.
TIPS
Transjugular intrahepatic portosystemic shunt (TIPS): This procedure involves placing a stent (a tubular device) in the middle of the liver. The stent connects the hepatic vein with the portal vein, which reroutes blood flow in the liver and helps relieve pressure in abnormal veins.
DSRS
Distal splenorenal shunt (DSRS): This procedure connects the vein from your spleen to the vein from the left kidney in order to reduce pressure in the varices and control bleeding.
