Doctor Evgeny SolomonovHead of the Department of Liver, Pancreas, and Biliary Surgery in the Transplantation Unit
Israeli medicine has achieved exceptional heights in the treatment of vascular liver pathologies through the integration of advanced science into clinical practice. At the Ichilov Center, doctors focus on minimally invasive technologies and hybrid surgeries that restore blood flow with minimal trauma. Personalized protocols ensure high effectiveness even in the most complex cases. This systematic approach provides long-term control over pressure in the portal system and prevents dangerous complications.
The conditions in the clinic meet the standards of the best five-star hotels, providing the patient with complete emotional peace. High-quality medical care and the aesthetics of the premises create a trusting environment for effective recovery. A personal attendant fully coordinates the process, addressing any organizational and language issues. This relieves unnecessary stress and allows the patient to focus solely on the recovery process. Professional curation makes the stay in the medical center clear, safe, and as comfortable as possible.
About the Disease
Portal hypertension is a pathological syndrome caused by a persistent increase in pressure in the portal vein system. It is important to understand that portal hypertension is almost always a consequence (of cirrhosis, thrombosis, or vascular pathology) that leads to serious restructuring of the entire circulatory system in the abdominal cavity.
Main Symptoms of the Disease
- Esophageal and gastric varices.
- Splenomegaly (pathological enlargement of the spleen).
- Ascites (fluid accumulation in the abdominal cavity).
- “Medusa head” (prominent venous pattern on the abdomen).
- Swelling of the lower extremities.
- Hepatic encephalopathy (neurological disorders).
- Gastrointestinal bleeding.
Treatment Methods for the Disease
The choice of therapy tactics for portal hypertension at Ichilov is based on a comprehensive analysis of the primary cause of vascular resistance and the current functional reserve of the patient's liver.
Medication Prevention with Beta-Blockers
At the early stages of pathology formation, when pressure in the portal vein is already elevated but the integrity of the vessels is not yet compromised, the main task becomes preventing the first episode of bleeding. Doctors prescribe non-selective beta-adrenergic blockers, which effectively reduce blood pressure by decreasing cardiac output and narrowing the vessels of the internal organs. Such planned therapy requires precise dosage adjustments under constant pulse monitoring, while Israeli doctors strive to achieve the safest possible balance. This approach allows patients to maintain stable conditions for years and avoid dangerous vein ruptures.
Endoscopic Ligation
When large varicose nodes are detected, which may rupture at any moment, or after a previous episode of hemorrhage, doctors proceed to mechanically protect the vessels. The ligation procedure involves placing miniature latex rings on the affected areas through a high-tech endoscope with a high-resolution digital matrix. The constricted tissues are gradually replaced by healthy scar tissue, completely eliminating the risk of re-bleeding from this node. The use of sedation makes the process comfortable for the patient, and the precision of Israeli endoscopists ensures the preservation of the integrity of the esophageal mucosa.
Transjugular Intrahepatic Portosystemic Shunt (TIPS)
If conservative measures and endoscopy do not yield the desired results or if the patient begins to accumulate fluid in the abdominal cavity, an advanced technology for creating an artificial vascular pathway is applied. Under radiological control, doctors place a special stent through the jugular vein, connecting the portal vein with the systemic circulation, bypassing the affected liver. This allows for an immediate release of critical pressure and restoration of normal circulation without resorting to major abdominal surgery. At Ichilov, this procedure is considered one of the most effective alternatives to surgery, as it is characterized by a short recovery period.
Diuretic Support for Ascites
Ichilov specialists combine loop and potassium-sparing diuretics to gently remove excess moisture from the body without disrupting the electrolyte balance. Monitoring weight and biochemical blood parameters becomes a daily routine, helping to avoid complications on the kidneys. A well-structured diuretic therapy scheme significantly improves the quality of life, allowing the patient to breathe more freely and move without significant discomfort.
Therapeutic Paracentesis
In situations where medications cease to manage the volume of fluid and the abdomen becomes tense, doctors resort to the procedure of direct evacuation of ascites. The manipulation is performed under mandatory ultrasound control, which eliminates accidental damage to internal organs by the needle. To compensate for protein loss, the patient is simultaneously administered albumin solutions, maintaining blood viscosity and arterial pressure at normal levels. This auxiliary, yet extremely important intervention provides immediate relief, alleviating pressure on the diaphragm and digestive organs, which is critically important for stabilizing overall well-being.
Correction of Blood Coagulation
At any stage of portal hypertension development, especially before invasive procedures, it is crucial to maintain the correct balance of coagulation factors. The liver, when diseased, stops producing the necessary proteins, so doctors use infusions of fresh frozen plasma or special protein concentrates. This approach minimizes the risks of accidental bleeding and prepares the body for more radical treatment methods. Careful monitoring of the coagulogram gives doctors confidence in the safety of each manipulation, turning fragile equilibrium into a controlled therapeutic process.
Diagnostic Methods for the Disease
Timely diagnosis of portal hypertension is critically important for preventing life-threatening complications, which is why all studies at Ichilov Clinic are conducted using high-precision expert-class equipment. The prompt identification of pathology allows doctors to immediately begin the active phase of therapy, and all procedures are planned in advance and carried out in a short time to ensure maximum patient safety.
First Day
Upon arrival at the clinic, the patient meets with the attending physician, who collects a detailed medical history and studies the history of disease development. The specialist conducts a thorough examination to assess the clinical signs of the disease, and then provides recommendations for tests that will help see the complete picture of the patient's condition.
Second Day
To verify the diagnosis and assess hemodynamics, a comprehensive set of laboratory and instrumental studies is prescribed:
- Complete blood count
- Biochemical blood test with liver function tests
- Coagulogram
- Serum ammonia level determination
- Testing for viral hepatitis markers
- Ultrasound examination of the abdominal organs with Doppler imaging
- Multi-slice computed tomography with contrast
- Esophagogastroduodenoscopy
- Liver elastography
- Liver scintigraphy
- Portomanometry
Third Day
Based on the results obtained, the attending physician gathers a consultation to develop a plan, and such collaborative work of experts allows for the creation of the most relevant treatment plan. This collegial approach, in turn, helps avoid medical errors, and the combination of different specialists' experiences into one strategy contributes to the development of an individual scheme ideally suited for this clinical case.
Diagnostic Procedures
- Computed Tomography
- Ultrasound
- Blood Biochemistry
How Much Does Treatment Cost in Israel
The cost of treating portal hypertension in Israel is determined individually and depends on the complexity of the clinical case, the volume of diagnostics, the chosen treatment tactics, and the need for minimally invasive or endovascular interventions. The level of the clinic, the involvement of specialized professionals, and the use of modern technologies are also taken into account.
To obtain an accurate cost estimate for treatment, it is necessary to contact the clinic's consultant at the phone number provided on the website.
Advantages of Treatment in Israel
- Internationally recognized doctors with specialized expertise in hepatology and vascular surgery
- Modern minimally invasive and endovascular treatment techniques
- High-precision diagnostics using expert equipment
- Individual interdisciplinary approach to each patient
- Comfortable treatment conditions and support at all stages
Even before arriving at the Israeli clinic, the patient can request an online consultation with a specialized expert. During this consultation, they receive personalized recommendations, answers to key questions, and information about available modern treatment methods.