ArticleIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2017
Shunt occlusion for portosystemic shunt syndrome related refractory hepatic encephalopathy-A single-center experience in 21 patients from Kerala.
Article in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed, 30 citations in OpenAlex.
- Reducing the Risk of Overt Hepatic Encephalopathy Recurrence: A Narrative Review.Journal of clinical and translational hepatology · 2026Review
- Embolization of spontaneous portosystemic shunts for refractory hepatic encephalopathy in cirrhosis patients:A meta-analysis.Hepatology forum · 2026Review
- BRTO: Past, Present, and Future Directions.Interventional radiology (Higashimatsuyama-shi (Japan) · 2026Review
- Improved clinical outcomes following embolization of extrahepatic portosystemic shunts in cirrhotic patients with recurrent hepatic encephalopathy.World journal of hepatology · 2025Article
- [Current status of interventional therapy for hepatic encephalopathy associated with spontaneous portosystemic shunts].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025Review
- Non-variceal Extrahepatic Portosystemic Shunts: A Review of Pathogenesis, Diagnosis, and Treatment.Journal of clinical and translational hepatology · 2025Review
- [Paradoxical roles of spontaneous portosystemic shunts and their management strategy in splenectomy with devascularization].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025Article
- Effects of shunt embolization on hepatic encephalopathy recurrence in patients with major portosystemic shunts: A systematic review and meta‑analysis.Biomedical reports · 2025Article
- The clinical relevance of acute-on-chronic liver failure in medical procedures: Endoscopy, interventions and surgery.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Repeated rough coiling technique of portosystemic shunt: A novel treatment for hepatic encephalopathy.Radiology case reports · 2024Article
- To evaluate the prevalence of spontaneous portosystemic shunts in decompensated cirrhosis patients and its prognostic significance.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2023Observational
- Closing spontaneous portosystemic shunts in cirrhosis: Does it make sense? Does it work? What does it take?Metabolic brain disease · 2023Review
- [Endovascular therapy accompanied by spontaneous portosystemic shunts for overt hepatic encephalopathy].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Article
- Clinical outcomes related to portal pressures before and after embolization of large portosystemic shunts in cirrhosis.SAGE open medicine · 2023Article
- North American Practice-Based Recommendations for Transjugular Intrahepatic Portosystemic Shunts in Portal Hypertension.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022Review
- Successful treatment of recurrent hepatic encephalopathy with revision of transjugular intrahepatic portasystemic shunt and embolisation of splenorenal shunt.BMJ case reports · 2021Article
- Friend or Foe? Spontaneous Portosystemic Shunts in Cirrhosis-Current Understanding and Future Prospects.Canadian journal of gastroenterology & hepatology · 2021Review
- Early, late, or no shunt embolization in patients with cirrhosis- and portosystemic shunt-related hepatic encephalopathy.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2020Article
- Intractable hepatic encephalopathy in cirrhotic patients: mid-term efficacy of balloon-occluded retrograde portosystemic shunt obliteration.European radiology · 2020Article
- Spontaneous porto-systemic shunts in liver cirrhosis: Clinical and therapeutical aspects.World journal of gastroenterology · 2020Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionLarge spontaneous portosystemic shunts (SPSS) are seen in a subset of patients with liver disease and medically refractory recurrent/persistent hepatic encephalopathy (MRHE). Shunt occlusion has been shown to improve clinical outcomes.
methodsWe retrospectively analyzed patient characteristics, SPSS attributes, procedural features, baseline clinical and investigational parameters, neurological outcomes, adverse effects (procedure and portal hypertension related), and risk factors predicting outcomes in liver disease patients undergoing shunt occlusion procedure for MRHE.
resultsBetween October 2016 and July 2017, 21 patients (Child-Pugh score, CTP 6 to 13) with mean model of end-stage liver disease (MELD) and MELD-sodium scores 15.7 and 19.3 respectively with MRHE [3-cirrhotic Parkinsonism (CP)] were diagnosed to have single or multiple large SPSSs. A total of 29 shunts were occluded (1 surgical, 20 non-surgical). Recurrent and persistent HE and CP markedly improved in the short (n=20, 1 to 3 months), intermediate (n=12, 3 to 6 months), and long (n=7, 6 to 9 months) follow up. None had spontaneous or persistent HE at a median follow up 105 (30 to 329) days (p<0.05). Motor, speech, sleep abnormalities, daily activities of living, and liver disease severity scores improved significantly on follow up. Baseline arterial ammonia showed a statistically significant reduction in all time periods of follow up after shunt occlusion (p<0.05). CTP >11 predicted mortality post shunt occlusion (p=0.04). Embolization of large SPSS in liver disease patients with MRHE and modestly preserved liver function is safe and efficacious and associated with improved quality of life and can function as a bridge to liver transplantation in accurately selected patients.
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