Indications and Contraindications

Indications

Control of acute hemorrhage from esophageal varices not amenable to or failing medical therapy, e. g., pharmacotherapy, balloon tamponade, endoscopic variceal sclerotherapy, in patients with liver cirrhosis and portal hypertension Control of bleeding gastric or intestinal varices Prevention of recurrent variceal bleeding after initial control Complicated Budd-Chiari syndrome

Contraindications

Portal vein thrombosis, even with recanalization (cavernomatous transformation) Inferior vena cava thrombosis

Extensive adhesions from previous operative procedures in the right upper quadrant (relative contraindication)

Severe medical comorbidities (e.g., mitral regurgitation, severe aortic stenosis, etc.)

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