Endovascular therapy accompanied by spontaneous portosystemic shunts for overt hepatic encephalopathy
10.3760/cma.j.cn501113-20210705-00315
- VernacularTitle:伴自发性门体分流道显性肝性脑病的血管内治疗
- Author:
Tian ZHAO
1
;
Jiayu HUANG
;
Chenhan LIU
;
Renbiao CHEN
;
Wenlong FAN
;
Weiliang ZHENG
Author Information
1. 浙江大学医学院附属邵逸夫医院放射科，杭州 310000
- Keywords:
Hepatic encephalopathy;
Embolization;
Portal hypertension
- From:
Chinese Journal of Hepatology
2023;31(2):181-185
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To preliminarily evaluate the safety and efficacy of shunt-related interventional therapy accompanied with spontaneous portosystemic shunts (SPSS) in patients with hepatic encephalopathy (HE).Methods:Case data on six patients who underwent interventional therapy accompanied by SPSS for HE from January 2017 to March 2021 were collected to evaluate the efficacy and postoperative complications.Results:All six patients underwent SPSS. Four patients had hepatitis B cirrhosis; one had alcoholic cirrhosis; and one had hepatic arterioportal fistula-induced portal hypertension. Child-Pugh liver function scores were C and B in three and three cases, respectively. The SPSS type was gastrorenal shunt in two cases; portal-thoracic-azygos venous in two cases; portal-umbilical-iliac venous in one case; and portal-splenic venous - inferior vena cava in one case. Two of them had previously had a transjugular intrahepatic portosystemic shunt (TIPS), and there were SPSS prior to TIPS. Five cases (5/6) successfully underwent shunt embolization, and one case (1/6) underwent stent implantation for flow restriction (portal-umbilical-iliac vein). The technical success rate was 100%. HE did not recur during hospitalization or the three-month follow-up period. However, one case had a recurrence of HE within a year after surgery and was treated symptomatically, while another experienced gastrointestinal bleeding a year after surgery..Conclusion:SPSS embolization or flow restriction is effective and safe for improving HE patients' symptoms.
