scholarly journals After A Year of Follow Up Non-Cirrhotic Portal Hypertension Patient with Partial Spleen Embolization (PSE) Management

2022 ◽  
Vol 22 (3) ◽  
pp. 249-253
Author(s):  
Akhmadu Muradi ◽  
Chyntia Olivia Maurine Jasirwan ◽  
Raden Suhartono ◽  
Patrianef Darwis ◽  
Dedy Pratama ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Major Complication ◽  
Long Term Results ◽  
Endoscopic Variceal Ligation ◽  
Adequate Treatment ◽  
Femoral Access ◽  
Clinical Complications ◽  
Cardiovascular Center ◽  
Spleen Mass

Non-cirrhotic portal hypertension (NCPH) is a heterogeneous group of liver disorders leading to portal hypertension. There are multiple approaches to managing portal hypertension' clinical complications to treat/prevent spontaneous hemorrhage by mitigating thrombocytopenia. Portal hypertension complications have been traditionally managed with serial endoscopic variceal ligation (EVL) or with invasive open surgical procedures such as orthotopic liver transplantation (OLT) or portosystemic shunting, splenectomy.6–9 There are several risks associated with splenectomies, such as hemorrhagic complications or intraoperative blood loss.5,6,14 Partial Spleen Embolization (PSE) ‎may overcome the limitations of splenectomy and provide patients with an alternative treatment. An eighteen-year-old male has a splenomegaly history since he was 12 years old and has recurring hematemesis and melena. After performing abdominal computed tomography, laboratory studies, and several endoscopies, the results indicated secondary hypersplenism due to non-cirrhotic portal hypertension. The patient had 13 endoscopies and 2 EVL in 5 years. Despite adequate treatment, the patients developed recurrent variceal bleeding and no improvement in blood function. The patient underwent PSE at Integrated Cardiovascular Center in Dr. Cipto Mangunkusumo, General Hospital, Jakarta, Indonesia. It was performed through the femoral access with a PVA (polyvinyl alcohol) embolus. The procedure went successful, and there was no major complication with the patient. Twenty days after the patient had an abdominal CT scan, it showed no abscess, and the spleen volume was reduced by 20%. Long-term results over a  year after the procedure are presented. PSE is a safe, effective, semi-invasive alternative to splenectomy in non-cirrhotic portal hypertension because it preserves functional spleen mass and avoids postprocedure accelerated liver disease or encephalopathy.

A Comparative Study of the Efficacy of the Modified Sugiura Procedure and the Hassab Procedure for Treatment of Rebleeding after Endoscopic Variceal Ligation Due to Portal Hypertension

2016 ◽  
Vol 82 (6) ◽  
pp. 557-564 ◽  
Author(s):  
Qiang Wang ◽  
Xiong Ding
Keyword(s):  
Portal Hypertension ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Endoscopic Variceal Ligation ◽  
Transfusion Rate ◽  
Significant Difference ◽  
Sugiura Procedure ◽  
Surgical Duration ◽  
Blood Loss Volume

Although the modified Sugiura procedure and Hassab procedure have been used for many years, it remains unclear as to which is more effective for the treatment of rebleeding due to portal hypertension (PHT) after endoscopic variceal ligation (EVL). Hence, we conducted a retrospective study to compare the efficacy of these two procedures for treatment of rebleeding due to PHTafter EVL. Of 66 patients diagnosed with PHT and rebleeding after EVL in our institute from January 2007 to January 2014, 31 underwent the modified Sugiura procedure (Group S), whereas 35 underwent the Hassab procedure (Group H). The surgical duration, blood loss volume, blood transfusion rate, postoperative complication rate, postoperative rebleeding rate, postoperative hospital stay, and long-term complication rates were compared between groups. Greater blood loss volume ( P = 0.036), higher blood transfusion rate ( P = 0.002), and longer surgical duration ( P < 0.001) were observed in Group S than in Group H. There was no significant difference in the rate of short-term postoperative rebleeding between the groups ( P = 0.695), although the rate of long-term rebleeding was lower ( P = 0.031) in Group S. Recurrence of esophageal varices in Group S was less frequent in Group H ( P = 0.002), although there was no significant difference between the groups in the rates of recurrence of gastric varices and other long-term complications ( P > 0.05). The modified Sugiura procedure is more effective than the Hassab procedure for the treatment of rebleeding after EVL.

Long-Term Results of Esophagogastric Devascularization and Splenectomy Associated with Endoscopic Treatment in Schistosomal Portal Hypertension

2010 ◽  
Vol 34 (11) ◽  
pp. 2682-2688 ◽  
Author(s):  
Fabio Ferrari Makdissi ◽  
Paulo Herman ◽  
Vincenzo Pugliese ◽  
Roberto de Cleva ◽  
William Abrão Saad ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Endoscopic Treatment ◽  
Long Term Results

The long-term results of hyoid-sternohyoid grafts in the correction of subglottic stenosis

1986 ◽  
Vol 100 (6) ◽  
pp. 665-674 ◽  
Author(s):  
A. P. Freeland
Keyword(s):  
Granulation Tissue ◽  
Major Complication ◽  
Subglottic Stenosis ◽  
Long Term Results ◽  
Repair Site ◽  
Long Term Follow Up

AbstractThe long-term follow-up of eight patients with established subglottic stenosis managed with a composite hyoid-sternohyoid graft is reported. Four of these patients were children. All but one of the patients were extubated within four months of surgery. The reconstructed airway is shown to grow with age and re-stenosis has not occurred. Apart from post-operative granulation tissue at the repair site, the major complication has been a breathy voice in two children due to overwidening of the larynx.

scholarly journals Treatment and prevention of bleeding from varicose veins of the esophagus

2021 ◽  
Vol 1 (215) ◽  
pp. 80-83
Author(s):  
Eduard Mogilevets ◽  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
High Efficiency ◽  
Varicose Veins ◽  
Mortality Rates ◽  
Long Term Results ◽  
Recurrent Bleeding ◽  
Chronic Liver Diseases ◽  
Treatment And Prevention

Liver cirrhosis is the result of various chronic liver diseases. Portal hypertension is a serious complication of cirrhosis. Its consequences, in turn, along with other complications are gastroesophageal varicose bleeding, which cause high mortality rates. The article contains analysis of the results of laparoscopic esophagogastric devascularization without esophageal transsection and splenectomy in a patient with liver cirrhosis portal hypertension and recurrent bleeding from varicose veins of the esophagus. First successful surgery according to this method was introduced in the Grodno Municipal Clinical Hospital No. 4 in November 2011. Immediate and long-term results show a rather high efficiency of using this operation in the treatment and prevention of bleeding from varicose veins of the esophagus with cirrhosis. It is advisable to conduct further studies of the effectiveness of using this operation, despite the encouraging results of the use of this modification of laparoscopic esophagogastric devascularization.

scholarly journals Future Directions in the Management of Twin-to-Twin Transfusion Syndrome

2016 ◽  
Vol 19 (3) ◽  
pp. 285-291 ◽  
Author(s):  
Robert Cincotta ◽  
Sailesh Kumar
Keyword(s):  
Laser Ablation ◽  
Loss Rate ◽  
New Technologies ◽  
Fetal Loss ◽  
Major Complication ◽  
Long Term Results ◽  
Optimum Frequency ◽  
Future Directions ◽  
Short And Long Term

Twin-to-twin transfusion syndrome (TTTS) is the major complication of monochorionic (MC) pregnancy. The outcomes of this condition have been significantly improved after the introduction and widespread uptake of fetoscopic laser ablation over the last decade. However, there is still a significant fetal loss rate and morbidity associated with this condition. Improvements in the management of TTTS will require improvements in many areas. They are likely to involve refinements in the prediction of the disease and clarification of the optimum frequency of surveillance and monitoring. Improvements in training for fetoscopic surgery as well as in the technique of fetoscopic laser ablation may lead to better outcomes. New technologies as well as a better understanding of the pathophysiology of TTTS may lead to adjuvant medical therapies that may also improve short- and long-term results.

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