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Portal hypertension is a serious medical condition that can have life-threatening consequences, including cirrhosis of the liver, gastrointestinal bleeding, and ascites. Fortunately, there are several effective treatments available for those diagnosed with this condition. NYC Liver, Pancreatic & Bile Duct Oncological Surgeon Dmitri Alden, MD, FACS, explores the different options available for portal hypertension treatment.

What is Portal Hypertension?

First, it’s important to understand portal hypertension and how it affects the body. Portal hypertension occurs when the pressure inside the portal vein, which carries blood from the stomach and intestines to the liver, is higher than normal. This increased pressure can lead to damage to the liver and other organs.

Common causes of portal hypertension include:

  • Cirrhosis
  • Blood clots
  • Hepatitis

The first line of treatment for portal hypertension is often medication. Medications such as beta-blockers and nitrates can help reduce the pressure in the portal vein and prevent complications such as bleeding from esophageal varices. However, medication is not always effective, and some patients may require more invasive procedures.

Treating Portal Hypertension

One of the most common procedures used to treat portal hypertension is transjugular intrahepatic portosystemic shunt (TIPS) surgery. TIPS is a minimally invasive procedure that involves creating a shunt between the portal vein and the hepatic vein, which allows blood to bypass the liver and reduce pressure in the portal vein. TIPS has been shown to be effective in reducing the risk of bleeding and improving the quality of life in patients with portal hypertension.

However, not all patients are candidates for TIPS surgery. In some cases, surgical correction of portal hypertension may be necessary. Various shunting procedures have been developed over time, including the calibrated portocaval shunt and the splenorenal shunt. These procedures should only be performed by hepatobiliary surgeons with prior transplantation experience.  Dr. Dmitri Alden and his interventional radiology team routinely perform this procedure.

Surgical shunts are extremely challenging because of the dramatically increased risk of bleeding with portal hypertension. Meticulous technical skills and knowledge of anatomy are necessary. Although surgical shunts are not used as often these days, they are still performed with good results.

In addition to medication and surgery, there are other treatments available for portal hypertension. These include endoscopic therapy, which involves using an endoscope to treat bleeding esophageal varices and balloon tamponade, which involves using a balloon to apply pressure to bleeding varices.

New York Best Doctor for Surgery of The Liver, Pancreas and Biliary System

Portal hypertension is a serious medical condition that can have life-threatening consequences. It’s important for patients with portal hypertension to receive appropriate treatment as soon as possible to prevent complications and improve their quality of life. If you have been diagnosed with portal hypertension, it’s important to schedule an exam and consultation with Dr. Alden as soon as possible. He can develop the right treatment plan for you and include the most modern and effective therapies and techniques. Contact us today in New York to learn more.

Posted on behalf of Dmitri Alden, MD, FACS

186 E 76th Street,
New York, NY 10021

Phone: (212) 434-6216


Monday - Friday 9:00 AM to 5:PM

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Dmitri Alden, MD, FACS

(212) 434-6216

186 E 76th Street,
New York, NY 10021