• Internal medicine · Apr 2020

    Case Reports

    Intractable Hepatic Encephalopathy with a Large Portosystemic Shunt Successfully Treated Using Shunt-preserving Disconnection of the Portal and Systemic Circulation.

    • Masafumi Haraguchi, Satoshi Hirai, Yutaka Nakamura, Tetsuhiro Otsuka, Hideki Ishimaru, Ryu Sasaki, Masanori Fukushima, Satoshi Miuma, Hisamitsu Miyaaki, and Kazuhiko Nakao.
    • Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Japan.
    • Intern. Med. 2020 Apr 15; 59 (8): 1047-1051.

    AbstractHepatic encephalopathy (HE) is a significant symptom of decompensated liver cirrhosis. Occlusion of portosystemic shunts is used to treat refractory HE. Nevertheless, these treatments often cause adverse events, such as ascites and esophageal varices. We treated a 57-year-old man with refractory HE using shunt-preserving disconnection of the portal and systemic circulation (SPDPS). After SPDPS, there were no obvious complications, and the patient's ammonia level significantly decreased. To date, the patient has not experienced recurrent HE. SPDPS appears to be a safe and effective treatment method for portosystemic encephalopathy.

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