scholarly journals Long Term Results of Balloon-Occluded Retrograde Transvenous Obliteration for Portosystemic Shunt Encephalopathy in Patients with Liver Cirrhosis and Portal Hypertension

2014 ◽  
Vol 61 (1.2) ◽  
pp. 1-8 ◽  
Author(s):  
HIROTO INOUE ◽  
KEIGO EMORI ◽  
ATSUSHI TOYONAGA ◽  
KAZUHIKO OHO ◽  
MASAFUMI KUMAMOTO ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Portosystemic Shunt ◽  
Long Term Results

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 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.

scholarly journals Systemic and Splanchnic Lipopolysaccharide and Endothelin-1 Plasma Levels in Liver Cirrhosis before and after Transjugular Intrahepatic Portosystemic Shunt

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Jiaxiang Meng ◽  
Qing Wang ◽  
Kai Liu ◽  
Shuofei Yang ◽  
Xinxin Fan ◽  
...  
Keyword(s):  
Blood Flow ◽  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Bacterial Translocation ◽  
Portosystemic Shunt ◽  
Before And After ◽  
Intrahepatic Portosystemic Shunt ◽  
Cirrhotic Patients

Lipopolysaccharide (LPS) and endothelin- (ET-) 1 may aggravate portal hypertension by increasing intrahepatic resistance and splanchnic blood flow. In the portal vein, after TIPS shunting, LPS and ET-1 were significantly decreased. Our study suggests that TIPS can benefit cirrhotic patients not only in high hemodynamics related variceal bleeding but also in intestinal bacterial translocation associated complications such as endotoxemia.

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

Long‐term outcomes of oesophagogastric devascularization and splenectomy in patients with portal hypertension and liver cirrhosis

2020 ◽  
Vol 90 (11) ◽  
pp. 2269-2273
Author(s):  
Lingpeng Yang ◽  
Zifei Zhang ◽  
Jinli Zheng ◽  
Junjie Kong ◽  
Xianwei Yang ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Long Term Outcomes

scholarly journals Portosystemic shunting procedures for complicated portal hypertension: modern opportunities of mini-invasive technique

2021 ◽  
Vol 26 (3) ◽  
pp. 34-45
Author(s):  
Yu. V. Khoronko ◽  
E. V. Kosovtsev ◽  
M. A. Kozyrevskiy ◽  
E. Yu. Khoronko ◽  
N. A. Krivorotov ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Varicose Veins ◽  
Sharp Decrease ◽  
Portosystemic Shunt ◽  
Long Term Results ◽  
Invasive Technique ◽  
Recurrent Bleeding ◽  
Clinical Group ◽  
Shunt Thrombosis ◽  
Group I

Aim. To improve the results of treatment for patients with complicated portal hypertension of cirrhotic genesis using the transjugular intahepatic portosystemic shunt with endovascular obliteration of the inflow pathways to the esophageal-gastric varicose veins.Material and methods. Transjugular intahepatic portosystemic shunt was performed in 172 patients with gastroesophageal variceal bleeding. The patients were divided into 3 clinical groups. The shunting procedure was applied to 62 patients. Another 110 patients underwent transjugular intahepatic portosystemic shunt and selective obliteration of the esophageal-gastric vein inflow pathways. The short-term and long-term results (up to 140 months), the incidence of thrombosis, recurrent bleeding and mortality, as well as their relationship with the established risk factors for complications were traced.Results. All patients achieved an effective reduction in the portosystemic pressure gradient and a reduction in the manifestations of portal hypertension. Recurrence of bleeding caused by shunt thrombosis occurred in 23 (13.3%) patients. In clinical group I (n = 62), this complication was noted in 9 (14.5%) patients, in II (n = 54) – 11 (20.4%) cases, in III (n = 56) – only in 3 (5.4%) cases. Bleeding-free survival decreased from 1.0 to 0.82 in 83.9 months, then plateaued. A sharp decrease in the Kaplan–Meier curve from 1.0 to 0.88 was observed within 24.5 months after the intervention. The largest number of deaths was in group I (30.6%), the smallest in group III (7.1%).Conclusion. Transjugular intahepatic portosystemic shunt supplemented by obliteration the inflows of the esophagealgastric varicose veins provides complete eradication of varicose veins, helps to reduce the frequency of recurrent bleeding and death.

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