Management of Portal Hypertension

In recent centuries, an increasing understanding of the physiologic changes resulting in clinically significant portal hypertension has led to innumerable advances in the management of these patients. Highly morbid operative decompression has been largely replaced by medical therapy, endoscopic intervention, and endovascular techniques. A number of novel operations to relieve portal hypertension are still occasionally indicated due to the limited availability of liver transplantation. The high complexity of these patients requires a multidisciplinary approach with a clear understanding of both the natural history of cirrhosis and portal hypertension as well as the evolving techniques available to alter the progression of this disease.