Summary
The effects of obliteration of portal systemic shunts (PSS) in 5 patients with non-cirrhotic hepatic encephalopathy is reported. All patients had a history of disturbance of consciousness for several years, and examinations revealed large PSS, most of which connecting the left gastric vein to the left renal vein. After the obliteration of PSS, portal vein pressure elevated, the shunt ratio of the portal blood flow decreased, the indocyanine green disappearance rate increased, and serum albumin increased. Blood ammonia (NH3) decreased significantly accompanied by disappearance of hepatic encephalopathy. This treatment may open a way to improve the quality of life in patients with large PSS without severe hepatic injury.
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Kimura K, Sekiguchi C, Koitabashi T, et al. A case of hepatic encephalopathy due to porto-renal shunt. Jpn J Intern Med 1978;67:900–901. (in Japanese)
Harada E, Komachidani K, Ohtake H, et al. A case of hepatic encephalopathy showing peculiar porto-caval shunt. Acta Hepat Jap 1980;21:944. (in Japanese)
Ohkubo H, Hata K, Akamatsu K, et al. A case of spontaneous splenorenal gastrorenal shunt showing recurrent hepatic encephalopathy-like attack. Liver, Biliary Tract, Pancreas (Kan-Tan-Sui) 1981;2:231–235. (in Japanese)
Norimoto, M, Horie Y, Suoh T, et al. A case of hepatic encephalopathy due to splenocaval shunt. Liver, Biliary Tract, Pancreas (Kan-Tan-Sui) 1981;3:131–135. (in Japanese)
Nakashima K, Hirashima T, Hara T, et al. A case of Inose-type hepatic encephalopathy with measurement of portal blood pressure before and after ligation of shunt vein. J Jap Society for Clin Surg 1982;43:1165. (in Japanese)
Takashi M, Igarashi M, Ueno M, et al. A case of Inose-type hepatic encephalopathy with no association of portal hypertension. Acta Hepat Jap 1982;23:546–551. (in Japanese)
Furukawa T, Nemoto Y, Kaneko K, et al. A case of gastro-renal shunt without liver cirrhosis. Jap J Clin Radiol 1982;27:851–854. (in Japanese)
Utsunomiya H, Matsuo H, Okazaki M: A case of Inose-type hepatic encephalopathy due to superior mesenteric-inferior vena caval shunt. Liver, Biliary Tract, Pancreas (Kan-Tan-Sui) 1984;8:283–287. (in Japanese)
Hirota T, Ohno N, Hino H, et al. A case of Inose-type hepatic encephalopathy due to superior mesenteric—inferior vena caval shunt. Liver, Biliary Tract, Pancreas (Kan-Tan-Sui) 1985;10:649–654. (in Japanese)
Matsuura B, Akamatsu K, Kitai K, et al. A case report of portal systemic encephalopathy with normal portal vein pressure and non-cirrhosis of the liver. Jpn J Gastroenterol 1987;84:1684–1689. (in Japanese)
Clarke B, Ellis MJC, Leung V, et al. Reversal of hepatic encephalopathy and alteration in amino acid profiles after blocking a surgical splenorenal shunt by interventional radiological techniques. J Hepatol 1989;8:325–329.
Uflacker R, Silva A, Carneiro D’Albuquerque LA, et al. Chronic portosystemic encephalopathy: embolization of portosystemic shunts. Radiology 1988;165:721–725.
Hanna S, Smith R, Herderson J, et al. Reversal of hepatic encephalopathy after occlusion of total portasystemic shunts. Am J Surg 1981;142:285–289.
Potts JR, Herderson J, Millikan W, et al. Restoration of portal venous perfusion and reversal of encephalopathy by balloon occlusion of portal systemic shunt. Gastroenterology 1984;87:208–212.
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Ito, T., Ikeda, N., Watanabe, A. et al. Obliteration of portal systemic shunts as therapy for hepatic encephalopathy in patients with non-cirrhotic portal hypertension. Gastroenterol Jpn 27, 759–764 (1992). https://doi.org/10.1007/BF02806529
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DOI: https://doi.org/10.1007/BF02806529