Surgery for Portal Hypertension

  • R. Häring
  • A. Hirner


The portal system drains all of the venous blood from the gastrointestinal tract and in part from the esophagus, spleen, and pancreas and transports it to the liver. Four large veins contribute to the portal vein (Fig. 28.1): the superior coronary vein of the stomach, the superior mesenteric vein, the splenic vein, and the inferior mesenteric vein. The portal vein itself, the splenic vein, the superior mesenteric vein, and rarely the coronary vein are of importance for the surgery of portal hypertension. An exact knowledge of the anatomic relationship of these large veins is, therefore, indispensable. The portal vein runs in the hepatoduodenal ligament (Fig. 28.2). Anteriorly, it is accompanied by the hepatic artery and the common bile duct. If cirrhosis of the liver is present, one usually finds enlarged and engorged lymph nodes caudal to the portal vein, which can make the dissection of the vessel more difficult. Immediately before entering the liver parenchyma, the portal vein divides into two large branches that lead to the right and left hepatic lobe. Occasionally, the right hepatic artery, originating from the superior mesenteric artery, runs caudal to the portal vein. Many variations are possible (one must be careful of accidental injuries during dissection).


Portal Vein Portal Hypertension Renal Vein Esophageal Varix Variceal Bleeding 
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Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • R. Häring
  • A. Hirner

There are no affiliations available

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