| Journal: | Revista médica de Chile |
| Database: | PERIÓDICA |
| System number: | 000455037 |
| ISSN: | 0034-9887 |
| Authors: | Benítez, Carlos1 Muñoz, Ana1 Poniachik, Jaime2 Ramírez, Felipe2 Muñoz, Claudia2 Cermenati, Tomás2 Martínez, Nicolás2 Díaz, Pía3 Meneses, Luis4 |
| Institutions: | 1Pontificia Universidad Católica de Chile, Departamento de Gastroenterología, Santiago de Chile. Chile 2Universidad de Chile, Hospital Clínico, Santiago de Chile. Chile 3Hospital Clínico UC Christus, Centro de Terapia Endovascular, Santiago de Chile. Chile 4Pontificia Universidad Católica de Chile, Departamento de Radiología, Santiago de Chile. Chile |
| Year: | 2022 |
| Volumen: | 150 |
| Number: | 7 |
| Pages: | 879-888 |
| Country: | Chile |
| Language: | Español |
| Document type: | Artículo |
| Approach: | Aplicado, descriptivo |
| English abstract | Background: Hepatic encephalopathy (HE) is a common complication of cirrhosis associated with a reduced survival. The presence of high-flux spontaneous porto-systemic shunts can induce HE even in patients with preserved liver function. Aim: To evaluate the effect of spontaneous porto-systemic shunt embolization (SPSE) over HE and its long-term evolution. Material and Methods: Retrospective analysis of 11 patients (91% males) with severe HE non-responsive to medical treatment in whom a SPSE was performed. The grade of HE (employing West Haven score), survival, MELD and Child-Pugh score, ammonia levels, degree of disability (employing the modified Rankin scale (mRs)) were evaluated before and at thirty days after procedure. Results: The most common etiology found was non-alcoholic steatohepatitis (63.6%). A reduction of at least two score points of HE was observed in all patients after thirty days. There was a significant reduction on median (IQR) West Haven score from 3 (2-3) at baseline to 1 (0-1) after the procedure (p < 0.01). Twelve months survival was 63.6%. There was a decrease in median ammonia level from 106.5 (79-165) (ug/dL) to 56 (43-61) after SPSE (p = 0.006). The median mRS score before and after the procedure was 3 (3-5) and 1 (1-2.5), respectively (p < 0.01). Conclusions: According to our experience, SPSE is a feasible and effective alternative to improve HE and functionality of patients with refractory EH |
| Disciplines: | Medicina |
| Keyword: | Gastroenterología, Terapéutica y rehabilitación, Encefalopatía hepática, Cirrosis hepática, Embolización arterial |
| Keyword: | Gastroenterology, Therapeutics and rehabilitation, Hepatic encephalopathy, Liver cirrhosis, Arterial embolization |
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