scholarly journals Vasoactive intestinal peptide in canine portosystemic shunt in the absence of portal hypertension

2021 ◽  
Vol 11 (1) ◽  
pp. 39-41
Author(s):  
Mitsuhiro Isaka ◽  
Hiroshi Ueno
Keyword(s):  
Blood Flow ◽  
Portal Hypertension ◽  
Vasoactive Intestinal Peptide ◽  
Vascular Anomaly ◽  
Portosystemic Shunt ◽  
Portal System ◽  
Enzyme Linked Immunosorbent Assay ◽  
Congenital Portosystemic Shunt ◽  
Significant Difference ◽  
Portal Veins

Background: The congenital portosystemic shunt (PSS) is a common vascular anomaly in dogs. Vasoactive intestinal peptide (VIP) is produced in various organs (including the small intestine, large intestine, and pancreas), leading to abdominal vasodilation, increased blood flow, increased pancreatic blood flow, and promotion of pancreatic endocrine and exocrine secretions. However, there have been no reports on the concentration of VIP in the portal and peripheral veins in canine PSS. Aim: The aim of this pilot study was to evaluate whether dogs with PSS have a different VIP concentration in their portal system in general. Methods: Six dogs with an extrahepatic portosplenic shunt were included in the study. Blood samples were taken from the saphenous and portal veins during PSS ligation surgery with an amerid constrictor, to evaluate and compare the VIP concentration in both samples. VIP was measured using a commercial canine enzyme-linked immunosorbent assay kit. Results: The breeds included Mongrels (n = 2), Norfolk Terriers (n = 1), Miniature Dachshunds (n = 1), and Maltese (n = 2), and their ages were 9.3 ± 6.5 months; the bodyweight was 3.3 ± 0.8 kg. The concentration of VIP in the saphenous vein was 17.75 ± 13.88 pg/ml; on the contrary, the concentration of VIP in the portal vein was 29.7 ± 20.29 pg/ml. There was no significant difference in the VIP concentration between veins. Conclusion: There was no difference in the VIP concentration between the portal and saphenous veins, suggesting a non-association between VIP and the PSS, in the absence of portal hypertension.

scholarly journals THE EFFECTIVENESS OF SPLENORENAL SHUNT IN TREATMENT OF PREHEPATIC PORTAL HYPERTENSION IN CHILDREN

2021 ◽  
Vol 29 (5) ◽  
pp. 565-572
Author(s):  
R.V. Zhezhera ◽  
◽  
Keyword(s):  
Blood Flow ◽  
Portal Hypertension ◽  
Varicose Veins ◽  
Portosystemic Shunt ◽  
Splenorenal Shunt ◽  
Portal System ◽  
Recurrent Bleeding ◽  
Esophageal Variceal ◽  
Results Of Treatment

Objective. To evaluate the results of treatment of prehepatic portal hypertension (PPH) in children by method of side-to-side splenorenal bypass. Methods. A retrospective, monocentric analysis of 114 patients with prehepatic portal hypertension was carried out in the period from 2000 to 2018. The age of the patients was from 6 months up to 18 years, the average age 10,1±3,8 years (M±σ). All patients underwent side-to-side splenorenal shunt. In the postoperative period, on the 7<sup>th</sup> day, ultrasound examination of the abdominal organs with Doppler sonography (US) was performed to assess the volume of the spleen, the rate of portohepatic perfusion, the rate of blood flow along the side-to-side splenorenal shunt, as well as to assess its diameter. Control US was performed after the 1<sup>st</sup>, 3<sup>rd</sup>, 6<sup>th</sup>, 12<sup>th</sup> months; to assess the regression of esophageal and gastric varicose veins, the control esophagogastroduodenoscopy (EYD) was performed after 3<sup>rd</sup> , 6<sup>th</sup>, 12<sup>th</sup> months and then once a year. Subsequently, the control examination of the patients was carried out once a year. The follow-up was 2-18 years. Results. Out of 114 patients who underwent side - to - side splenorenal shunt, 5 (4,4%) patients had recurrent bleeding from the esophageal variceal vein at the follow-up period (2-18 years). One patient had intra-abdominal arrosive bleeding from side-to-side splenorenal shunt provoked by severe postoperative pancreatitis. The average diameter of the shunt was 12±1.9 mm. The spleen volume decreased by 39.7±10.3%. Portohepatic perfusion reduced by 39% in comparison with the indicators before surgery. The blood flow rate along the side -to-side splenorenal shunt was 2403±557.3 ml/min. in 95,4% of patients the regression of variceal vein was noted. Hypersplenism syndrome was arrested in 73.6% of children. Conclusion. Side -to- side splenorenal shunt is considered to be an effective method of portal decompression with the effectiveness inpreventingboth esophageal and gastricvariceal veins bleeding in 95,4% of patients. What this paper adds The results of treatment of the prehepatic portal hypertension by method of side-to-side splenorenal shunt have been firstly analyzed, and the effect of this variant of portosystemic shunt on portohepatic perfusion has been assessed. It has been established that this option of shunt is effective for the portal system decompression and occupies an intermediate position between selective and total variant of portosystemic shunt.

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.

scholarly journals Transjugular Intrahepatic Portosystemic Shunt: A Literature Review

2017 ◽  
Vol 34 (2) ◽  
pp. 114-122 ◽  
Author(s):  
Vicki R. Franklin ◽  
Layla Q. Simmons ◽  
Anthony L. Baker
Keyword(s):  
Portal Hypertension ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Venous Pressure ◽  
Portosystemic Shunt ◽  
Portal System ◽  
Refractory Ascites ◽  
Hepatic Veins ◽  
Technological Advances ◽  
Intrahepatic Portosystemic Shunt ◽  
Diseased Liver

Transjugular intrahepatic portosystemic shunt, or TIPS, is a procedure used to decompress the portal system resulting from portal hypertension. The technique was inadvertently discovered during a transjugular cholangiography procedure around 1969. Technological advances in the 1980s and 1990s have resulted in more positive outcomes for the TIPS procedure since its inception. There are several indications for performing the procedure, including refractory ascites, variceal bleeding, and portal hypertension. Liver disease can lead to portal hypertension, and few treatments are available; however, with TIPS, many patients obtain favorable results. The goal of placing an intrahepatic portosystemic shunt is to bypass the vascular resistance in the cirrhotic liver by creating a channel between the portal and hepatic veins, thereby reducing portal venous pressure and portal hypertension. Normal and diseased liver function is explained as well as the TIPS procedure process, materials, complications, and long-term outcomes.

Renal blood flow before and after portosystemic shunt in children with portal hypertension

2014 ◽  
Vol 30 (3) ◽  
pp. 295-299 ◽  
Author(s):  
Makhmud M. Aliev ◽  
Rustam Z. Yuldashev ◽  
Gulnara S. Adilova ◽  
Gulnora A. Yusupaileva
Keyword(s):  
Blood Flow ◽  
Portal Hypertension ◽  
Renal Blood Flow ◽  
Portosystemic Shunt ◽  
Before And After

scholarly journals Mortality and complications in patients with portal hypertension who underwent transjugular intrahepatic portosystemic shunt (TIPS) - 12 years experience

2012 ◽  
Vol 49 (2) ◽  
pp. 143-149 ◽  
Author(s):  
Fernanda Ribeiro Funes ◽  
Rita de C. M. A. da Silva ◽  
Paulo César Arroyo Jr. ◽  
William José Duca ◽  
Adinaldo Adhemar Menezes da Silva ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Hepatitis Virus ◽  
Early Death ◽  
Portosystemic Shunt ◽  
University Hospital ◽  
Portal System ◽  
Digestive Hemorrhage ◽  
Intrahepatic Portosystemic Shunt ◽  
Cirrhotic Patients

CONTEXT: Transjugular intrahepatic portosystemic shunt (TIPS) is the non-surgical treatment option with low level of morbi-mortality and possibility of accomplishment in patients with severe hepatic dysfunction which aims at decompressing the portal system treating or reducing the portal hypertension complications. OBJECTIVE: Outline the profile analyze global and early mortality, and the complications presented by cirrhotic patients who underwent TIPS for treatment of digestive hemorrhage by portal hypertension. METHOD: Retrospective study based on the data bank of cirrhotic patients' medical reports, who underwent TIPS for digestive hemorrhage by portal hypertension treatment who did not respond to clinical endoscopic treatment, and were assisted from 1998 to 2010 in the Liver Transplant Service at a university hospital. The study was approved by the Committee of Ethics and Research. RESULTS: The sample was comprised of 72 (84.7%) patients, being 57 (79.2%) males, average age 47.7 years (age range from 16 to 85 years and SD = 13), 21 (29.2%) patients presented liver disease as cause excessive intake of alcoholic drinks; 21 (29.2%) contamination by hepatitis virus, 16 (22.2%) excessive alcohol intake associated with virus and 14 (19.4%) patients presented other causes. As for initial classification, 14 (20%) had Child-Pugh A, 33 (47.1%) Child-Pugh B and 23 (32.9%) Child-Pugh C. Initial MELD was obtained in 68 patients being 37 (54.4%) higher than 15 points while 31 (45.6%) had up to 15 points. Early death occurred in 19 (26.4%). Global mortality occurred in 41 (60.3%). CONCLUSIONS: Mortality is directly related to clinical factors of patients, being Child-Pugh and MELD classifications predictors of mortality, with more impact in patients with Child-Pugh class C and MELD > 15. The complications found were similar to those described in the literature, although the dysfunction by stent stenosis (26.4%) was lower than in the most of the studies and the encephalopathy incidence (58.3%) was higher. Probably, the high incidence of encephalopathy is explained by the low incidence of stenosis.

Evolution of portal hypertension and mechanisms involved in its maintenance in a rat model

1985 ◽  
Vol 248 (6) ◽  
pp. G618-G625 ◽  
Author(s):  
E. Sikuler ◽  
D. Kravetz ◽  
R. J. Groszmann
Keyword(s):  
Blood Flow ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Rat Model ◽  
Portal Pressure ◽  
Portal System ◽  
Hypertensive Rats ◽  
Hemodynamic Changes ◽  
Sequence Of Events ◽  
Radioactive Microsphere

In rats with portal hypertension induced by partial ligation of the portal vein, we have recently demonstrated an increased portal venous inflow that becomes an important factor in the maintenance of portal hypertension. The sequence of events that leads into this circulatory disarray is unknown. We evaluated chronologically the chain of hemodynamic changes that occurred after portal hypertension was induced by partial ligation of the portal vein. In this model it is possible to follow, from the initiation of the portal-hypertensive state, the interaction between blood flow and resistance in the portal system as well as the relation between the development of portal-systemic shunting and the elevated portal venous inflow. The study was performed in 45 portal-hypertensive rats and in 29 sham-operated rats. Blood flow and portal-systemic shunting were measured by radioactive microsphere techniques. The constriction of the portal vein was immediately followed by a resistance-induced portal hypertension characterized by increased portal resistance (9.78 +/- 0.89 vs. 4.18 +/- 0.71 dyn X s X cm-5 X 10(4), mean +/- SE, P less than 0.01), increased portal pressure (17.7 +/- 0.9 vs. 9.5 +/- 0.6 mmHg, P less than 0.001), and decreased portal venous inflow (3.93 +/- 0.26 vs. 6.82 +/- 0.49 ml X min-1 X 100 g body wt-1, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Oral sodium phenylbutyrate for hyperammonemia associated with congenital portosystemic shunt: a case report

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Takeshi Sato ◽  
Tomohiro Ishii ◽  
Mototoshi Kato ◽  
Takayuki Oyanagi ◽  
Seishi Nakatsuka ◽  
...  
Keyword(s):  
Portosystemic Shunt ◽  
Psychomotor Development ◽  
Case Presentation ◽  
The Third ◽  
Congenital Portosystemic Shunt ◽  
Low Levels ◽  
Portal Veins ◽  
Branched Chain ◽  
Oral Sodium ◽  
Sodium Phenylbutyrate

AbstractObjectivesThe efficacy of sodium phenylbutyrate (SPB) for hyperammonemia associated with congenital portosystemic shunt (CPSS) remains unknown. We show the effectiveness of oral SPB.Case presentationOur patient had CPSS with severe hypoplasia of extrahepatic portal veins. At 9 months of age, to assess the efficacy of oral SPB, we evaluated the 24 h fluctuations of venous ammonia levels. In the first two days without SPB, ammonia levels were above 80 μmol/L for half a day. On the third and fourth days, administration of oral SPB three times a day decreased ammonia to acceptable levels, except at midnight. On the fifth day, another oral SPB administration at 8 pm decreased ammonia at midnight. Low levels of branched-chain amino acids, as well as coagulation disturbances, were observed without apparent symptoms. At 12 months of age, he showed normal psychomotor development.ConclusionsOral SPB may be effective for hyperammonemia associated with CPSS.

scholarly journals Protection of estrogen in portal hypertension gastropathy: an experimental model

2011 ◽  
Vol 48 (3) ◽  
pp. 211-216 ◽  
Author(s):  
Maria Isabel Morgan-Martins ◽  
Simone Iahnig Jacques ◽  
Renata Minuzzo Hartmann ◽  
Camila Moraes Marques ◽  
Cláudio Augusto Marroni ◽  
...  
Keyword(s):  
Antioxidant Enzymes ◽  
Portal Hypertension ◽  
Portal Vein ◽  
Experimental Model ◽  
Portal Pressure ◽  
The Other ◽  
Portal System ◽  
Sham Operation ◽  
Portal Vein Ligation ◽  
Significant Difference

CONTEXT: Portal hypertension is a complication secondary to cirrhosis that is characterized by increased blood flow and/or vascular resistance in the portal system, causing the appearance of a hyperdynamic collateral circulation. Partial portal vein ligation is an experimental model used in rats to study the pathophysiological mechanisms involved in pre-hepatic portal hypertension. Estrogen E2 is an antioxidant molecule with various physiological actions. OBJECTIVES: To evaluate the antioxidant activity of endogenous estrogen in an experimental model of partial portal vein ligation by comparing intact with castrated rats. METHODS: Twenty Wistar rats, weighing on average 250 g were used and divided into four groups: sham-operated (SO); intact (I) with partial portal vein ligation (I + PPVL), castrated (C) and castrated with partial ligation of the vein (C + PPVL). Day 1: castration or sham-operation; day 7, PPVL surgery; on day 15 post-PPVL, portal pressure in the mesenteric vein of rats was measured on polygraph Letica. Lipid peroxidation in the stomach was assessed using the technique of thiobarbituric acid reactive substances and activity of antioxidant enzymes superoxide dismutase, catalase and glutathione peroxidase. Statistical analysis was done with ANOVA - Student-Newman-Keuls (mean ± SE), and P<0.05 was considered as significant. RESULTS: Portal pressure was significantly increased in C + PPVL as compared to the other groups. There was no significant difference in the group of intact rats. TBARS showed significant damage in C and C + PPVL in relation to others. Antioxidant enzymes were significantly increased in the castrated rats with subsequent PPVL as compared to the other groups. CONCLUSION: We suggest that estrogen E2 plays a protective role in intact compared with castrated rats because it presents hydrophenolic radicals in its molecule, thus acting as an antioxidant in this experimental model.

scholarly journals Efficacy and safety of laparoscopic splenectomy for hypersplenism secondary to portal hypertension after transjugular intrahepatic portosystemic shunt

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yingying Li ◽  
Zuojin Liu ◽  
Chang’an Liu
Keyword(s):  
Portal Hypertension ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Laparoscopic Splenectomy ◽  
International Normalized Ratio ◽  
Ammonia Level ◽  
Portosystemic Shunt ◽  
Vein Thrombosis ◽  
Improve Liver Function ◽  
Significant Difference ◽  
Intrahepatic Portosystemic Shunt

Abstract Background Laparoscopic splenectomy (LS) being used after Transjugular intrahepatic portosystemic shunt (TIPS) has not been reported. This report aims to explore the feasibility, safety, and potential efficacy of LS after TIPS hypersplenism secondary to portal hypertension (PHT). Methods We retrospectively reviewed a series of six patients who underwent LS after TIPS for hypersplenism secondary to PHT between 2014 and 2020. The perioperative data and patients’ clinical outcomes were recorded. Results LS was successfully performed in all patients. Hypersplenism was corrected after LS in all six patients. Postoperative prothrombin time, prothrombin activity, international normalized ratio, and total bilirubin showed a trend toward improvement. The preoperative and 1-month postoperative albumin and activated partial thromboplastin levels showed no significant difference. Plasma ammonia level and thromboelastography indicators were ameliorated in two limited recorded patients. No postoperative complications such as subphrenic abscess, portal vein thrombosis, variceal bleeding, hepatic encephalopathy, and liver failure occurred during the 1-month follow-up period. Conclusion LS following TIPS is feasible, safe, and beneficial for patients with hypersplenism secondary to PHT. The following LS not only corrects the hypersplenism, but also has the potential to improve liver function.

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