J.Jpn. Surg. Soc.. 97(1): 4-12, 1996

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Feature topic

THE HISTORY OF THE TREATMENT FOR PORTAL HYPERTENSION

Until recently, the only effective treatment for bleeding esophageal varices was surgery, including portal-systemic shunts, nonshunting operations, and selective shunts. New operations were developed from the neccessity to find a better therapeutic modality for the treatment. This article describes the history of development of surgical treatment for portal hypertension as well as introducing the outline of several such procedures.
The history of nonoperative treatments, especially endoscopic injection screlotherapy, is also described : Endoscopic sclerotherapy as a treatment for bleeding esophageal varices had been employed before many definitive surgical procedures. In accordance with the development of fiberoptic endoscopy, endoscopic sclerotherapy came into prominance. The less invasive treatment is appreciated and popularized even among surgeons today, who once believed that shunt operation (or nonshunting operation) was the best modality of treatment for esophageal varices.
Finally, this article provides readers with a simplfied quide to Japanese participation in the development of treatrnent for esophagogastric varices.

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